Provider Demographics
NPI:1376709436
Name:VANLEEUWEN, STEPHANIE MICHELLE (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELLE
Last Name:VANLEEUWEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 W CHESTER PIKE
Mailing Address - Street 2:THE MARKET PLACE AT WESTTOWN
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-7705
Mailing Address - Country:US
Mailing Address - Phone:610-692-7208
Mailing Address - Fax:610-692-6865
Practice Address - Street 1:1502 W CHESTER PIKE
Practice Address - Street 2:THE MARKET PLACE AT WESTTOWN
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-7705
Practice Address - Country:US
Practice Address - Phone:610-692-7208
Practice Address - Fax:610-692-6865
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPTO19885225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist