Individual
STACEY ERIN DEVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1203 N 13TH ST, NORFOLK, NE 68701-2609
(402) 379-0632
Mailing address
2820 PINNACLE DR, NORFOLK, NE 68701-6501
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
685
NE
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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