Healthcare Provider Details

I. General information

NPI: 1891518239
Provider Name (Legal Business Name): KAMI STAHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SCHWIETERMAN ST
MINSTER OH
45865-8729
US

IV. Provider business mailing address

2105 FOX HOLLOW DR
COLUMBUS OH
43228-9582
US

V. Phone/Fax

Practice location:
  • Phone: 419-628-6920
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA010729
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: