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NPI Code Detail

MEDICARE: IAN MATHEW STEPHENS P.T.

MEDICARE: IAN MATHEW STEPHENS P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical Therapist8386OH

General Provider Information

NPI Number : 1104091800
Entity Type Code : Individual
Provider Name (Legal Business Name) : IAN MATHEW STEPHENS P.T.
Provider Business Mailing Address
First Line : 3035 WOOSTER RD
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-4144
Country : US
Telephone Number : 216-905-6671
Fax Number : 440-333-0910
Provider Business Practice Location Address
First Line : 3035 WOOSTER RD
Second Line :
City : ROCKY RIVER
State : OH
Zip : 44116-4144
Country : US
Telephone Number : 216-905-6671
Fax Number : 440-333-0910
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2008
Last Update Date : 11/07/2023

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