Provider Demographics
NPI:1275011033
Name:CLEMENT, STEPHEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:CLEMENT
Suffix:
Gender:M
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 1:3809 W CHESTER PIKE STE 150
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-0259
Mailing Address - Country:US
Mailing Address - Phone:610-359-5671
Mailing Address - Fax:610-359-1519
Practice Address - Street 1:780 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:610-873-4856
Practice Address - Fax:610-873-4859
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026997225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist