Provider Demographics
NPI:1598177529
Name:WINKLER, STEPHEN (PT)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:WINKLER
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 1:804 TOWNE PARK DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:RINCON
Mailing Address - State:GA
Mailing Address - Zip Code:31326-5133
Mailing Address - Country:US
Mailing Address - Phone:912-826-5450
Mailing Address - Fax:912-826-6413
Practice Address - Street 1:804 TOWNE PARK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:RINCON
Practice Address - State:GA
Practice Address - Zip Code:31326-5133
Practice Address - Country:US
Practice Address - Phone:912-826-5450
Practice Address - Fax:912-826-6413
Is Sole Proprietor?:No
Enumeration Date:2014-05-26
Last Update Date:2014-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT003438225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist