Provider Demographics
NPI:1619007416
Name:POSTMA, STEPHANIE JOY (ATC, LAT)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JOY
Last Name:POSTMA
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601A EAGLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHEPPARD AIR FORCE BASE
Mailing Address - State:TX
Mailing Address - Zip Code:76311
Mailing Address - Country:US
Mailing Address - Phone:940-855-7446
Mailing Address - Fax:
Practice Address - Street 1:#1 WEST MEDICAL COURT
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76310
Practice Address - Country:US
Practice Address - Phone:940-692-4688
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT31962255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer