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Individual
STEPHANIE E TOOTHAKER
Active
Individual
STEPHANIE E TOOTHAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204702
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010315131
—
VA
01
—
192935
BCBS PHYSICAL THERAPY
VA
01
—
7050849
AETNA
VA
01
—
P00396604
RAILROAD MEDICARE
VA
Enumeration date
10/24/2006
Last updated
04/26/2018
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