Individual
STACY LEIGH FANCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 666-7797
Mailing address
2401 S 31ST ST, TEMPLE, TX 76508-0001
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1129674
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1129674
LICENSE NUMBER
TX
Enumeration date
06/23/2009
Last updated
06/23/2009
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