Individual
JANELLE STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
38505 BROOTEN RD STE C, PACIFIC CITY, OR 97135-8049
(503) 965-6400
(503) 965-9555
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 238-8930
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63398
OR
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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