Provider Demographics
NPI:1881062701
Name:STEPHENSON, PEGGY (PT)
Entity type:Individual
Prefix:MRS
First Name:PEGGY
Middle Name:
Last Name:STEPHENSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W FIFTH ST
Mailing Address - Street 2:PHYSICAL THERAPY DEPART AT CITY HOSPITAL
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-2405
Mailing Address - Country:US
Mailing Address - Phone:330-386-2054
Mailing Address - Fax:330-386-2673
Practice Address - Street 1:425 W FIFTH ST
Practice Address - Street 2:PHYSICAL THERAPY DEPART AT CITY HOSPITAL
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2405
Practice Address - Country:US
Practice Address - Phone:330-386-2054
Practice Address - Fax:330-386-2673
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT008437225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist