Provider Demographics
NPI:1215728357
Name:GABBARD, STEPHEN LEON (DPT)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:LEON
Last Name:GABBARD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 1/2 CLIFTY ST STE 2&3
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-1733
Mailing Address - Country:US
Mailing Address - Phone:606-679-9245
Mailing Address - Fax:
Practice Address - Street 1:100 NEIGHBORLY WAY
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-6147
Practice Address - Country:US
Practice Address - Phone:606-679-9245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006121261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy