MEDICARE: MS. STEPHANIE MARIE RACE 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
1	225100000X	Physical Therapist	2305206049	VA
2	225100000X	Physical Therapist	21655	MD

General Provider Information

NPI Number	:	1689798183
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. STEPHANIE MARIE RACE PT

Provider Business Mailing Address
First Line	:	300 WESTMINSTER CANTERBURY DR
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22603-4216
Country	:	US
Telephone Number	:	800-492-9463
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 WESTMINSTER CANTERBURY DR
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22603-4216
Country	:	US
Telephone Number	:	800-492-9463
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	10/10/2012

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