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NPI Code Detail

MEDICARE: KAY ALVERTA STEVENS PT

MEDICARE: KAY ALVERTA STEVENS PT
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
1225100000XPhysical Therapist006630KY
2225100000XPhysical Therapist05005539AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
105005539AOTHERINPT LICENSE
2006630OTHERKYPT

General Provider Information

NPI Number : 1205420924
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAY ALVERTA STEVENS PT
Provider Business Mailing Address
First Line : 3626 GRANT LINE RD STE 105
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-2399
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3626 GRANT LINE RD STE 105
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-2399
Country : US
Telephone Number : 812-297-9342
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2021
Last Update Date : 02/23/2021

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Directions to “ KAY ALVERTA STEVENS PT” Practice Location

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