Provider Demographics
NPI:1508127242
Name:STONE, NAMI LYNN (MPT)
Entity Type:Individual
Prefix:MRS
First Name:NAMI
Middle Name:LYNN
Last Name:STONE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 STONE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-4789
Mailing Address - Country:US
Mailing Address - Phone:785-842-1422
Mailing Address - Fax:
Practice Address - Street 1:3510 CLINTON PL
Practice Address - Street 2:SUITE 110
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2195
Practice Address - Country:US
Practice Address - Phone:785-505-3780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-03387225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist