Individual
STEPHANIE MEDIATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1184 E MAIN RD, PORTSMOUTH, RI 02871-2333
(401) 682-2100
Mailing address
31 ISLINGTON AVE, PORTSMOUTH, RI 02871-5620
(401) 369-3496
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01627
RI
225100000X
Physical Therapist
10293
MA
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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