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NPI Code Detail

MEDICARE: JOHN WESLEY STAMMER P.T

MEDICARE: JOHN WESLEY STAMMER 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
1225100000XPhysical TherapistPT9114CA

General Provider Information

NPI Number : 1598885725
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN WESLEY STAMMER P.T
Provider Business Mailing Address
First Line : 7038 OWENSMOUTH AVE
Second Line :
City : CANOGA PARK
State : CA
Zip : 91303-3198
Country : US
Telephone Number : 818-999-4076
Fax Number : 818-999-0813
Provider Business Practice Location Address
First Line : 7038 OWENSMOUTH AVE
Second Line :
City : CANOGA PARK
State : CA
Zip : 91303-3198
Country : US
Telephone Number : 818-999-4076
Fax Number : 818-999-0813
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 07/08/2007

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