Individual
GARY M STEPHENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
242 FERN VALLEY RD, PHOENIX, OR 97535-9104
(541) 512-0757
(541) 535-6016
Mailing address
242 FERN VALLEY RD, PHOENIX, OR 97535-9104
(541) 512-0757
(541) 535-6016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3046
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269103
—
OR
Enumeration date
01/15/2007
Last updated
04/10/2008
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