Provider Demographics
NPI:1831357755
Name:HEATH-GYOROK, STEPHANIE LYNNE (PT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:HEATH-GYOROK
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 1:1713 MCCULLOUGH AVE NE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-2441
Mailing Address - Country:US
Mailing Address - Phone:256-337-9813
Mailing Address - Fax:
Practice Address - Street 1:120 GOVERNORS DR SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4320
Practice Address - Country:US
Practice Address - Phone:256-265-7952
Practice Address - Fax:256-265-7953
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH3834225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist