Provider Demographics
NPI:1508580556
Name:DEULEY, STEPHEN BERNARD
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:BERNARD
Last Name:DEULEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8501 PEPPERMILL RUN
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44023-1863
Mailing Address - Country:US
Mailing Address - Phone:216-401-7520
Mailing Address - Fax:
Practice Address - Street 1:8501 PEPPERMILL RUN
Practice Address - Street 2:
Practice Address - City:CHAGRIN FALLS
Practice Address - State:OH
Practice Address - Zip Code:44023-1863
Practice Address - Country:US
Practice Address - Phone:216-401-7520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3921225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist