Provider Demographics
NPI:1720200348
Name:STEPHANIE DILLINER PHYSICAL THERAPIST INC
Entity Type:Organization
Organization Name:STEPHANIE DILLINER PHYSICAL THERAPIST INC
Other - Org Name:PEDIATRIC MILESTONES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:DILLINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-855-5987
Mailing Address - Street 1:4794 CIRCLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:95252-8769
Mailing Address - Country:US
Mailing Address - Phone:866-855-5987
Mailing Address - Fax:866-907-2695
Practice Address - Street 1:4794 CIRCLE HILL DR
Practice Address - Street 2:
Practice Address - City:VALLEY SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:95252-8769
Practice Address - Country:US
Practice Address - Phone:866-855-5987
Practice Address - Fax:866-907-2695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty