Provider Demographics
NPI:1508609496
Name:STIPKOVICH, CAROLINE ELIZABETH (PT, DPT)
Entity type:Individual
Prefix:MISS
First Name:CAROLINE
Middle Name:ELIZABETH
Last Name:STIPKOVICH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:ELIZABETH
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8555 BRIDLEHURST TRL
Mailing Address - Street 2:
Mailing Address - City:KIRTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44094-5137
Mailing Address - Country:US
Mailing Address - Phone:414-807-4669
Mailing Address - Fax:
Practice Address - Street 1:3705 STATE RD # 102
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004-5904
Practice Address - Country:US
Practice Address - Phone:440-465-7670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT021254225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist