Healthcare Provider Details

I. General information

NPI: 1912822990
Provider Name (Legal Business Name): SHAWN STONE DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 FIKE REC CENTER
CLEMSON SC
29634-0001
US

IV. Provider business mailing address

205 FIKE REC CENTER
CLEMSON SC
29634-0001
US

V. Phone/Fax

Practice location:
  • Phone: 864-643-1344
  • Fax: 844-860-2335
Mailing address:
  • Phone: 864-643-1344
  • Fax: 844-860-2335

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number13520
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: