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General NPI Number Information
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NPI Number | 1558377572
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Entity Type | Individual
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Provider Name | STEPHANIE S CONLOW PT
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 12572 VALLEY VIEW ST
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City | GARDEN GROVE
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State | CA
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Zip | 92845-2006
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Country | US
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Telephone | 714-823-4400
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Fax | 714-823-4404
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Provider Business Mailing Address
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Address Line | 16405 WHITTIER BLVD
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City | WHITTIER
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State | CA
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Zip | 90603-3044
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Country | US
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Telephone | 714-823-4400
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Fax | 714-823-4404
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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 | 6058
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License Number State | AZ
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