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General NPI Number Information
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NPI Number | 1982976734
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Entity Type | Individual
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Provider Name | STACI HARR P.T.
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Gender | Female
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 2125 ROYCE ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-4714
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Country | US
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Telephone | 740-354-8634
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Fax |
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Provider Business Mailing Address
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Address Line | 1068 MORRIS LANE BLUE RUN RD
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City | LUCASVILLE
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State | OH
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Zip | 45648-8039
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Country | US
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Telephone | 740-285-4277
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 05235
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License Number State | OH
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