Healthcare Provider Details

I. General information

NPI: 1679861918
Provider Name (Legal Business Name): STEVEN J STALZER PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 W LIONSHEAD CIR UNIT B
VAIL CO
81657-5069
US

IV. Provider business mailing address

103 N MAIN ST STE 300
GREENVILLE SC
29601-2796
US

V. Phone/Fax

Practice location:
  • Phone: 970-470-4348
  • Fax:
Mailing address:
  • Phone: 864-528-5700
  • Fax: 864-528-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number7329
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: