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General NPI Number Information
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NPI Number | 1689853343
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Entity Type | Organization
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Legal Business Name | STELLY PHYSICAL &OCCUPATIONAL THERAPY
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 11/17/2008
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Provider Practice Location Address
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Address Line | 946 BEGLIS PARKWAY
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City | SULPHUR
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State | LA
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Zip | 70663
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Country | US
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Telephone | 337-558-5168
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Fax |
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Provider Business Mailing Address
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Address Line | 946 BEGLIS PARKWAY
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City | SULPHUR
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State | LA
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Zip | 70663
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Country | US
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Telephone | 337-558-5168
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PRESTON JOSEPH STELLY JR.
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Credential | DPT/MOT
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Telephone | 337-558-5168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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