Provider Demographics
NPI:1669613188
Name:STULTS, JANICE RUTH (LPTA)
Entity type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:RUTH
Last Name:STULTS
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 COUNTY ROAD 37
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-6295
Mailing Address - Country:US
Mailing Address - Phone:205-269-7782
Mailing Address - Fax:
Practice Address - Street 1:1944 COUNTY ROAD 37
Practice Address - Street 2:
Practice Address - City:HALEYVILLE
Practice Address - State:AL
Practice Address - Zip Code:35565-6295
Practice Address - Country:US
Practice Address - Phone:205-269-7782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL329225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant