Provider Demographics
NPI:1275090771
Name:S.T.O.N.E CLINIC PC
Entity Type:Organization
Organization Name:S.T.O.N.E CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEVAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:REINHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:701-873-5342
Mailing Address - Street 1:1307 CENTRAL AVE N
Mailing Address - Street 2:
Mailing Address - City:BEULAH
Mailing Address - State:ND
Mailing Address - Zip Code:58523-6003
Mailing Address - Country:US
Mailing Address - Phone:701-873-5342
Mailing Address - Fax:701-873-5649
Practice Address - Street 1:108 W MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:BEULAH
Practice Address - State:ND
Practice Address - Zip Code:58523
Practice Address - Country:US
Practice Address - Phone:701-880-8936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-21
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty