Healthcare Provider Details

I. General information

NPI: 1780589853
Provider Name (Legal Business Name): STEPHANIE STRAHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14540 STADLER RD
BLISSFIELD MI
49228-9520
US

IV. Provider business mailing address

14540 STADLER RD
BLISSFIELD MI
49228-9520
US

V. Phone/Fax

Practice location:
  • Phone: 419-787-5986
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number010664
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501011699
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: