Provider Demographics
NPI:1255671657
Name:MUNTZER, STEPHANIE M (PT, MPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:M
Last Name:MUNTZER
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 1:2166 BEAVER HILL RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:19425-2616
Mailing Address - Country:US
Mailing Address - Phone:484-614-0029
Mailing Address - Fax:
Practice Address - Street 1:864 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-2516
Practice Address - Country:US
Practice Address - Phone:610-581-0111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011682L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist