Provider Demographics
NPI:1275854549
Name:STONER, MARTHA MCDANIEL (PT, DPT)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:MCDANIEL
Last Name:STONER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:ELIZABETH
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:305 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:MT
Mailing Address - Zip Code:59729-8001
Mailing Address - Country:US
Mailing Address - Phone:334-868-9464
Mailing Address - Fax:406-682-6625
Practice Address - Street 1:305 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:MT
Practice Address - Zip Code:59729-8001
Practice Address - Country:US
Practice Address - Phone:406-682-6605
Practice Address - Fax:406-682-6625
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4800225100000X
CO10802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist