Provider Demographics
NPI:1700098456
Name:ZEIGLER, STACEY LYNN (PT)
Entity Type:Individual
Prefix:
First Name:STACEY
Middle Name:LYNN
Last Name:ZEIGLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 STONE RD
Mailing Address - Street 2:
Mailing Address - City:HARRISVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13648-3244
Mailing Address - Country:US
Mailing Address - Phone:315-543-7130
Mailing Address - Fax:
Practice Address - Street 1:540 STONE RD
Practice Address - Street 2:
Practice Address - City:HARRISVILLE
Practice Address - State:NY
Practice Address - Zip Code:13648-3244
Practice Address - Country:US
Practice Address - Phone:315-543-7130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0143762251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics