Provider Demographics
NPI:1407165913
Name:NOLTING, STEPHANIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:
Last Name:NOLTING
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:58 GLEN ROYAL DR
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81005-2263
Mailing Address - Country:US
Mailing Address - Phone:719-565-6678
Mailing Address - Fax:888-334-4957
Practice Address - Street 1:58 GLEN ROYAL DR
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81005-2263
Practice Address - Country:US
Practice Address - Phone:719-565-6678
Practice Address - Fax:888-334-4957
Is Sole Proprietor?:No
Enumeration Date:2010-09-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO114552251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist