Provider Demographics
NPI:1013198225
Name:HAMMOND, STEPHEN LOUIS (PT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LOUIS
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 COUNTRY CENTER DR
Mailing Address - Street 2:STE. B5
Mailing Address - City:PAGOSA SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:81147-8379
Mailing Address - Country:US
Mailing Address - Phone:970-731-9521
Mailing Address - Fax:970-731-9521
Practice Address - Street 1:135 COUNTRY CENTER DR
Practice Address - Street 2:STE. B5
Practice Address - City:PAGOSA SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:81147-8379
Practice Address - Country:US
Practice Address - Phone:970-731-9521
Practice Address - Fax:970-731-9521
Is Sole Proprietor?:No
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM3212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist