Provider Demographics
NPI:1467721290
Name:STERNER, JAVIN T (PT)
Entity Type:Individual
Prefix:
First Name:JAVIN
Middle Name:T
Last Name:STERNER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:807 WILLIAMSON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8560
Mailing Address - Country:US
Mailing Address - Phone:704-325-9162
Mailing Address - Fax:704-746-3158
Practice Address - Street 1:807 WILLIAMSON RD
Practice Address - Street 2:STE 106
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8560
Practice Address - Country:US
Practice Address - Phone:704-325-9162
Practice Address - Fax:704-746-3158
Is Sole Proprietor?:No
Enumeration Date:2011-12-23
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13391225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0397730034Medicare NSC