Provider Demographics
NPI:1164458766
Name:STIVERS, ELIZABETH RAWLINGS (PT, MPT)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:RAWLINGS
Last Name:STIVERS
Suffix:
Gender:F
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7926 PRESTON HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40219-3848
Mailing Address - Country:US
Mailing Address - Phone:502-964-5404
Mailing Address - Fax:502-964-6164
Practice Address - Street 1:7926 PRESTON HWY STE 101
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40219-3848
Practice Address - Country:US
Practice Address - Phone:502-964-5404
Practice Address - Fax:502-964-6164
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY004556225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist