MEDICARE: TERRANCE J STEPHENSON

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1851659585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRANCE J STEPHENSON

Provider Business Mailing Address
First Line	:	PO BOX 8514
Second Line	:
City	:	SPRING CREEK
State	:	NV
Zip	:	89815-0009
Country	:	US
Telephone Number	:	775-881-8249
Fax Number	:

Provider Business Practice Location Address
First Line	:	157 COUNTRY CLUB PKWY
Second Line	:
City	:	SPRING CREEK
State	:	NV
Zip	:	89815-5203
Country	:	US
Telephone Number	:	775-881-8249
Fax Number	:

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

Provider Enumeration Date	:	05/01/2012
Last Update Date	:	03/18/2015

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Directions to “ TERRANCE J STEPHENSON ” Practice Location

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