Individual
STACEY DANIELLE COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
183 MAIN ST STE D, TRUSSVILLE, AL 35173-1496
(205) 994-5161
Mailing address
823 PENNY LN, TRUSSVILLE, AL 35173-2503
(205) 994-5161
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH11680
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11680
PT
AL
Enumeration date
05/15/2019
Last updated
02/07/2024
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