Individual
STACY WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
179 STATION PL, SUITE 100, HURRICANE, WV 25526-6578
(304) 760-6300
(304) 201-5123
Mailing address
5474 SHAWNEE CIR APT. 30, HUNTINGTON, WV 25703-3377
(740) 671-8458
(304) 201-5123
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 003420
WV
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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