Provider Demographics
NPI:1831240175
Name:FRANKS, STACEY KIRK (PT)
Entity type:Individual
Prefix:MR
First Name:STACEY
Middle Name:KIRK
Last Name:FRANKS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 COUNTY ROAD 251
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-8755
Mailing Address - Country:US
Mailing Address - Phone:662-869-7153
Mailing Address - Fax:662-869-7153
Practice Address - Street 1:235 COUNTY ROAD 251
Practice Address - Street 2:
Practice Address - City:SALTILLO
Practice Address - State:MS
Practice Address - Zip Code:38866-8755
Practice Address - Country:US
Practice Address - Phone:662-869-7153
Practice Address - Fax:662-869-7153
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT3059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist