Provider Demographics
NPI:1134667819
Name:CORMIER, STEPHANIE S (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:S
Last Name:CORMIER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SHERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-1529
Mailing Address - Country:US
Mailing Address - Phone:508-324-5485
Mailing Address - Fax:
Practice Address - Street 1:68 DEAN ST
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2713
Practice Address - Country:US
Practice Address - Phone:508-824-1467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22692225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist