Healthcare Provider Details

I. General information

NPI: 1952430506
Provider Name (Legal Business Name): KARA L STAUFFER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 GARFIELD AVE SUITE 200
PARKERSBURG WV
26101-3247
US

IV. Provider business mailing address

415 36TH ST SUITE 100
PARKERSBURG WV
26101-1005
US

V. Phone/Fax

Practice location:
  • Phone: 304-865-6778
  • Fax: 304-865-7400
Mailing address:
  • Phone: 304-917-3660
  • Fax: 304-917-3674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number867
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT011855
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: