Provider Demographics
NPI:1568670487
Name:STEWART, DAVID HERRINGTON (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HERRINGTON
Last Name:STEWART
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 1:711 HUNTINGTON CHASE CT
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2690
Mailing Address - Country:US
Mailing Address - Phone:706-564-1974
Mailing Address - Fax:229-868-2175
Practice Address - Street 1:136 WEST DYKES STREET
Practice Address - Street 2:
Practice Address - City:COCHRAN
Practice Address - State:GA
Practice Address - Zip Code:31014
Practice Address - Country:US
Practice Address - Phone:478-394-7704
Practice Address - Fax:229-868-2175
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist