Healthcare Provider Details

I. General information

NPI: 1386122331
Provider Name (Legal Business Name): MARY CAITLIN STEVENSON-WILCOXSON PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY CAITLIN WILCOXSON PT, DPT

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16390 HIGHWAY 72
ROGERSVILLE AL
35652-8103
US

IV. Provider business mailing address

927 FRANKLIN ST SE
HUNTSVILLE AL
35801-4306
US

V. Phone/Fax

Practice location:
  • Phone: 256-539-2728
  • Fax:
Mailing address:
  • Phone: 256-539-2728
  • Fax: 256-539-2666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH9033
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: