Healthcare Provider Details

I. General information

NPI: 1790680684
Provider Name (Legal Business Name): STEPHANIE BETH LAKRITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1394 S US HIGHWAY 231
OZARK AL
36360-4416
US

IV. Provider business mailing address

103 PEARTREE CIR
DOTHAN AL
36301-5855
US

V. Phone/Fax

Practice location:
  • Phone: 334-443-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number50284
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: