Provider Demographics
NPI:1750306023
Name:LYNCH-STEMPFER, TARA K (DPT)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:K
Last Name:LYNCH-STEMPFER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:672 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-1349
Mailing Address - Country:US
Mailing Address - Phone:724-454-6125
Mailing Address - Fax:
Practice Address - Street 1:672 3RD AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:PA
Practice Address - Zip Code:15147-1349
Practice Address - Country:US
Practice Address - Phone:724-454-6125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADAPT001715225100000X
MI5501302039225100000X
PAPT018172225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103082165Medicaid
480930Medicare PIN