Individual
MRS. BRANDI R STOUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
11638 HIGHWAY 27 STE 1, SUMMERVILLE, GA 30747-8515
(706) 857-6366
(706) 857-6372
Mailing address
PO BOX 949, ROME, GA 30162-0949
(706) 857-6366
(706) 857-6372
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT005657
GA
225100000X
Physical Therapist
PTH3178
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051556285STO
PIN
AL
01
—
515-29673
BCBS OF ALABAMA
AL
01
—
S89453
UPIN
AL
Enumeration date
06/30/2006
Last updated
12/21/2023
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