Provider Demographics
NPI:1093010688
Name:GRIFFIE, STEPHANIE LEIGH (DPT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:LEIGH
Last Name:GRIFFIE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:LEIGH
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:19126 SOUTH HWY 421
Mailing Address - Street 2:
Mailing Address - City:HYDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41749
Mailing Address - Country:US
Mailing Address - Phone:606-672-4546
Mailing Address - Fax:606-672-4547
Practice Address - Street 1:3104 PINE TOP RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-6202
Practice Address - Country:US
Practice Address - Phone:606-862-8333
Practice Address - Fax:606-862-8618
Is Sole Proprietor?:No
Enumeration Date:2011-01-13
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-005721225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist