Healthcare Provider Details

I. General information

NPI: 1639493703
Provider Name (Legal Business Name): KRISTEN M. STEVENS, DPT, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2010
Last Update Date: 03/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 FREEPORT RD
SHARPSBURG PA
15215-3215
US

IV. Provider business mailing address

524 COLQUITT DR
PITTSBURGH PA
15238-2444
US

V. Phone/Fax

Practice location:
  • Phone: 412-720-9496
  • Fax:
Mailing address:
  • Phone: 412-720-9496
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT005689L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT005689L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT005689L
License Number StatePA

VIII. Authorized Official

Name: DR. KRISTEN MOORE STEVENS
Title or Position: PRESIDENT/OWNER
Credential: MSPT, OCS, DPT
Phone: 412-720-9496