Provider Demographics
NPI:1891954814
Name:LIEB, STEFANIE MAIRE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:MAIRE
Last Name:LIEB
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 1:310 PENN ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HOLLIDAYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16648-2044
Mailing Address - Country:US
Mailing Address - Phone:814-695-2923
Mailing Address - Fax:814-695-2924
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:PA
Practice Address - Zip Code:16686-1810
Practice Address - Country:US
Practice Address - Phone:814-684-6309
Practice Address - Fax:814-684-6312
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT019344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist