Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 005716 | KY |
N | 2251G0304X | Physical Therapist - Geriatrics | 005716 | KY |
NPI | 1295307536 |
---|---|
Provider Name | Laura Joan Stebbins |
First Address | Louisville, KY 40202-1218 |
Second Address | Louisville, KY 40202-1218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2021 |
Last Update Date | 05/08/2021 |