Provider Demographics
NPI:1295828093
Name:STOKER, MARY FRANCIS (PT)
Entity Type:Individual
Prefix:
First Name:MARY FRANCIS
Middle Name:
Last Name:STOKER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 E SOUTHERLAND ST
Mailing Address - Street 2:
Mailing Address - City:WALLACE
Mailing Address - State:NC
Mailing Address - Zip Code:28466-2331
Mailing Address - Country:US
Mailing Address - Phone:910-285-1650
Mailing Address - Fax:910-285-1675
Practice Address - Street 1:121 W MAIN ST
Practice Address - Street 2:
Practice Address - City:BEULAVILLE
Practice Address - State:NC
Practice Address - Zip Code:28518-8803
Practice Address - Country:US
Practice Address - Phone:910-298-6455
Practice Address - Fax:910-298-6405
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9351208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC711904Medicaid
NC711904Medicaid