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General NPI Number Information
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NPI Number | 1982786166
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Entity Type | Individual
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Provider Name | STEPHANIE M BURNETT LPT
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 11/22/2011
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Provider Practice Location Address
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Address Line | 609 W LIBERTY ST
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City | HUBBARD
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State | OH
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Zip | 44425-1750
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Country | US
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Telephone | 330-534-8500
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Fax | 330-534-3926
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Provider Business Mailing Address
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Address Line | 6545 SPENCER CLARK RD
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City | FOWLER
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State | OH
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Zip | 44418-9761
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Country | US
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Telephone | 330-772-0351
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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 | PT09681
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License Number State | OH
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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 | PT020704
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License Number State | PA
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