Provider Demographics
NPI:1063645232
Name:MEANS, STEPHENIE JO (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:STEPHENIE
Middle Name:JO
Last Name:MEANS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:DR
Other - First Name:STEPHENIE
Other - Middle Name:JO
Other - Last Name:KRAYCSIR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:222 S GILLETTE AVENUE SUITE 603
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716
Mailing Address - Country:US
Mailing Address - Phone:307-696-6070
Mailing Address - Fax:307-682-4996
Practice Address - Street 1:222 S GILLETTE AVENUE SUITE 603
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716
Practice Address - Country:US
Practice Address - Phone:307-696-6070
Practice Address - Fax:307-682-4996
Is Sole Proprietor?:No
Enumeration Date:2009-09-03
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY1322225100000X
WYWY-1322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist