Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | ||
N | 2251E1200X | Ergonomics | ||
N | 225XE1200X | Ergonomics | ||
N | 2251G0304X | Physical Therapist - Geriatrics | ||
N | 2251H1200X | Hand | ||
N | 2251N0400X | Physical Therapist - Neurology | ||
N | 2251P0200X | Physical Therapist - Pediatrics | ||
N | 2251S0007X | Physical Therapist - Sports | ||
N | 2251X0800X | Physical Therapist - Orthopedic | ||
N | 225200000X | Physical Therapy Assistant |
NPI | 1003560400 |
---|---|
Provider Name | Joshua Stephens |
First Address | Wytheville, VA 24382-4136 |
Second Address | Wytheville, VA 24382-4136 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2022 |
Last Update Date | 05/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004021 | PHYSICAL THERAPY LICENSE (01) | WV |