Provider Demographics
NPI:1598051500
Name:MCCAIN, STEPHEN LEE (DPT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:LEE
Last Name:MCCAIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LEE LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLINTON
Mailing Address - State:LA
Mailing Address - Zip Code:70438-4341
Mailing Address - Country:US
Mailing Address - Phone:985-590-8995
Mailing Address - Fax:
Practice Address - Street 1:3223 BIAZZA ST C
Practice Address - Street 2:
Practice Address - City:FT. BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28307
Practice Address - Country:US
Practice Address - Phone:985-590-8995
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23638225100000X
FL31317225100000X
LA07940225100000X
NCCP006278T225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist