Provider Demographics
NPI:1144388828
Name:STAHR, PHILLIP E (MSPT)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:E
Last Name:STAHR
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8851 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5214
Mailing Address - Country:US
Mailing Address - Phone:561-819-0186
Mailing Address - Fax:561-819-5690
Practice Address - Street 1:16244 MILITARY TRL
Practice Address - Street 2:420
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6534
Practice Address - Country:US
Practice Address - Phone:561-819-0186
Practice Address - Fax:561-819-5690
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18722225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist