Individual
MS. STEPHANIE LISA MCNULTY
Active
Individual
MS. STEPHANIE LISA MCNULTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5829
SC
225100000X
Physical Therapist
PT009286
GA
225100000X
Physical Therapist
Primary
PTP-PT-LIC-9391
MT
Other
Enumeration date
09/19/2012
Last updated
07/13/2021
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