Provider Demographics
NPI:1851782916
Name:POPIELARZ, STEPHEN J (LAT/ATC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:POPIELARZ
Suffix:
Gender:M
Credentials:LAT/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21491 GREAT MILLS ROAD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20653-1394
Mailing Address - Country:US
Mailing Address - Phone:301-866-2459
Mailing Address - Fax:
Practice Address - Street 1:21491 GREAT MILLS ROAD
Practice Address - Street 2:
Practice Address - City:LEXINGTON PARK
Practice Address - State:MD
Practice Address - Zip Code:20653-1394
Practice Address - Country:US
Practice Address - Phone:301-866-2459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer