Individual
STEPHANIE R HINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009940A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100257920G
GROUP MEDICAID
IN
01
—
156546
GROUP MEDICARE
IN
05
—
200965550A
—
IN
Enumeration date
08/12/2009
Last updated
05/16/2011
Update your record
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