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General NPI Number Information
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NPI Number | 1902583362
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Entity Type | Individual
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Provider Name | STACY LYN NEUSCHAEFER PT
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Gender | Female
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Dates
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Enumeration Date | 06/28/2023
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 5909 NW EXPRESSWAY STE 229
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City | OKLAHOMA CITY
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State | OK
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Zip | 73132-5161
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Country | US
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Telephone | 801-440-5592
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Fax | 801-206-3059
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Provider Business Mailing Address
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Address Line | 2021 E VILLAGE GREEN CIR STE C
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City | DRAPER
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State | UT
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Zip | 84020-5500
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Country | US
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Telephone | 801-440-5592
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Fax | 801-206-3059
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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 | 2973
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License Number State | OK
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