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NPI Code Detail

MEDICARE: STEPHEN R CONRAD PT

MEDICARE: STEPHEN R CONRAD PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT01529OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PT01529OTHEROHOT PT ATC BOARD

General Provider Information

NPI Number : 1467442962
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN R CONRAD PT
Provider Business Mailing Address
First Line : 1225 E WATERLOO RD
Second Line :
City : AKRON
State : OH
Zip : 44306-3805
Country : US
Telephone Number : 330-724-7545
Fax Number : 330-724-8727
Provider Business Practice Location Address
First Line : 1225 E WATERLOO RD
Second Line :
City : AKRON
State : OH
Zip : 44306-3805
Country : US
Telephone Number : 330-724-7545
Fax Number : 330-724-8727
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2005
Last Update Date : 07/20/2010

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