Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | RTO000342 | PA |
NPI | 1912477076 |
---|---|
Provider Name | Michelle Stehman |
First Address | West Chester, PA 19380-1378 |
Second Address | West Chester, PA 19380-1378 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2018 |
Last Update Date | 03/12/2018 |