Provider Demographics
NPI:1770904872
Name:TEPROVICH, STANLEY MARC JR (DPT)
Entity type:Individual
Prefix:
First Name:STANLEY
Middle Name:MARC
Last Name:TEPROVICH
Suffix:JR
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 1:2000 OXFORD DR STE 211
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1898
Mailing Address - Country:US
Mailing Address - Phone:412-283-0260
Mailing Address - Fax:
Practice Address - Street 1:100 SIENA DR STE 165
Practice Address - Street 2:
Practice Address - City:UPPER ST CLAIR
Practice Address - State:PA
Practice Address - Zip Code:15241-1361
Practice Address - Country:US
Practice Address - Phone:412-409-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-17
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023254225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist