Provider Demographics
NPI:1073735130
Name:STEPHANIE DILLINER, PHYSICAL THERAPIST INC
Entity Type:Organization
Organization Name:STEPHANIE DILLINER, PHYSICAL THERAPIST INC
Other - Org Name:PEDIATRIC MILESTONES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DILLINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-598-0042
Mailing Address - Street 1:8192 CROTTY WAY
Mailing Address - Street 2:
Mailing Address - City:VALLEY SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95252-9074
Mailing Address - Country:US
Mailing Address - Phone:866-855-5987
Mailing Address - Fax:866-907-2695
Practice Address - Street 1:8192 CROTTY WAY
Practice Address - Street 2:
Practice Address - City:VALLEY SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95252-9074
Practice Address - Country:US
Practice Address - Phone:866-855-5987
Practice Address - Fax:866-907-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty