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Individual
STACEY L CAVANAUGH
Active
Individual
STACEY L CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0014389
CO
225100000X
Physical Therapist
2011031127
MO
225100000X
Physical Therapist
9976
MN
Other
Enumeration date
10/10/2011
Last updated
05/23/2022
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