Provider Demographics
NPI:1790458172
Name:STONE, CLAIRE MARIE (PT)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:MARIE
Last Name:STONE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:MARIE
Other - Last Name:HUMPHRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1125 N COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-1908
Mailing Address - Country:US
Mailing Address - Phone:479-713-8630
Mailing Address - Fax:479-713-8639
Practice Address - Street 1:1125 N COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-1908
Practice Address - Country:US
Practice Address - Phone:479-713-8630
Practice Address - Fax:479-713-8639
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4537225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist