Individual
AMANDA L STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
865 N MAIN ST, CANTON, IL 61520-1264
(309) 649-1572
(309) 649-1581
Mailing address
135 N WILLIAMSBURG DR, BLOOMINGTON, IL 61704-3528
(309) 661-8823
(309) 661-8801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-019514
IL
225100000X
Physical Therapist
2012023605
MO
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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