Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 4245 | OR |
N | 2251N0400X | Physical Therapist - Neurology | 4245 | OR |
NPI | 1508181546 |
---|---|
Provider Name | Mrs. Shawndi L Stahl |
First Address | Bend, OR 97701-3200 |
Second Address | Bend, OR 97701-3200 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2010 |
Last Update Date | 24/10/2013 |