Individual
MS. STEPHANI L POE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3122 BRETTWOOD CIR, DECATUR, IL 62526-2425
(217) 876-4600
(217) 876-4625
Mailing address
817 E ILLINOIS ST, ARTHUR, IL 61911-1631
(217) 876-4600
(217) 876-4625
Taxonomy
Speciality
Code
Description
License number
State
146M00000X
Intermediate Emergency Medical Technician
000921426
IL
225200000X
Physical Therapy Assistant
Primary
160002266
IL
Other
Enumeration date
08/01/2012
Last updated
08/01/2012
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