Individual
MRS. KIMBERLY MARIE STUMPHAUZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
137 WINCKLES ST, ELYRIA, OH 44035
(440) 366-5993
(440) 366-5313
Mailing address
137 WINCKLES ST, ELYRIA, OH 44035
(440) 366-5993
(440) 366-5313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT06051
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000192879
ANTHEM BLUE CROSS BLUE SH
OH
05
—
2167462
—
OH
01
—
341490517042
CARESOURCE
OH
01
—
654140
AETNA
OH
Enumeration date
04/08/2006
Last updated
04/29/2025
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