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General NPI Number Information
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NPI Number | 1063780427
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Entity Type | Individual
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Provider Name | STACEY ANN KASTOR P.T.
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Gender | Female
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Dates
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Enumeration Date | 12/13/2011
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 1100 E STATE RD
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City | NEWCOMERSTOWN
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State | OH
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Zip | 43832-9446
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Country | US
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Telephone | 740-498-4444
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Fax |
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Provider Business Mailing Address
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Address Line | 1419 5TH ST SE
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City | NEW PHILADELPHIA
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State | OH
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Zip | 44663-9301
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Country | US
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Telephone | 330-365-1170
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 10674
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License Number State | OH
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