Provider Demographics
NPI:1124575584
Name:STEIN, JANE C (PT)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:C
Last Name:STEIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8475 WANN DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9534
Mailing Address - Country:US
Mailing Address - Phone:256-704-1700
Mailing Address - Fax:256-704-1701
Practice Address - Street 1:8475 WANN DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9534
Practice Address - Country:US
Practice Address - Phone:256-704-1700
Practice Address - Fax:256-704-1701
Is Sole Proprietor?:No
Enumeration Date:2016-09-02
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01518225100000X
ALPTH8829225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILENROLLEDMedicaid