Provider Demographics
NPI:1720503022
Name:STEPHENS, CORY DAVID (DPT)
Entity Type:Individual
Prefix:
First Name:CORY
Middle Name:DAVID
Last Name:STEPHENS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 MORGAN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-6476
Mailing Address - Country:US
Mailing Address - Phone:205-230-0400
Mailing Address - Fax:205-230-0410
Practice Address - Street 1:2910 MORGAN RD STE 110
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-6476
Practice Address - Country:US
Practice Address - Phone:205-230-0400
Practice Address - Fax:205-230-0410
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2017-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist