Provider Demographics
NPI:1528005246
Name:STILES, RICHARD LEHMAN JR (PT)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEHMAN
Last Name:STILES
Suffix:JR
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:P O BOX 396
Mailing Address - Street 2:
Mailing Address - City:LEDERACH
Mailing Address - State:PA
Mailing Address - Zip Code:19454-0396
Mailing Address - Country:US
Mailing Address - Phone:215-256-1991
Mailing Address - Fax:215-256-1895
Practice Address - Street 1:703 HARLEYSVILLE PIKE
Practice Address - Street 2:RT 113
Practice Address - City:LEDERACH
Practice Address - State:PA
Practice Address - Zip Code:19454-0396
Practice Address - Country:US
Practice Address - Phone:215-256-1991
Practice Address - Fax:215-256-1895
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT006436L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA5012004OtherAETNA US HEALTHCARE
PAST450968Medicare ID - Type Unspecified