Individual
SARAH STEPHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9494 E TS AVE, VICKSBURG, MI 49097-8501
(269) 870-6528
Mailing address
9494 E TS AVE, VICKSBURG, MI 49097-8501
(269) 870-6528
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
N354183
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N354183
—
MI
Enumeration date
08/26/2018
Last updated
08/26/2018
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