Provider Demographics
NPI:1245805225
Name:PHILIP, STERLY MARY (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STERLY
Middle Name:MARY
Last Name:PHILIP
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 949
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30162-0949
Mailing Address - Country:US
Mailing Address - Phone:770-749-0250
Mailing Address - Fax:
Practice Address - Street 1:1566 ROME HWY
Practice Address - Street 2:
Practice Address - City:CEDARTOWN
Practice Address - State:GA
Practice Address - Zip Code:30125-4403
Practice Address - Country:US
Practice Address - Phone:770-749-0250
Practice Address - Fax:770-749-0086
Is Sole Proprietor?:No
Enumeration Date:2021-05-23
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCP007690T225100000X
HIPT-5179-0225100000X
GAPT014013225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist