Provider Demographics
NPI:1265928667
Name:STEPHENS, ERICA FAYER (PT, DPT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:FAYER
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:DONNA
Other - Last Name:FAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-362-8684
Practice Address - Street 1:2295 TOWNE LAKE PKWY STE 148
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189
Practice Address - Country:US
Practice Address - Phone:770-926-2744
Practice Address - Fax:770-926-2794
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT013509225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist