Provider Demographics
NPI:1881883742
Name:HUNTER, STEPHANIE IRENE (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:IRENE
Last Name:HUNTER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MISS
Other - First Name:STEPHANIE
Other - Middle Name:IRENE
Other - Last Name:MENICOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 EARL NORTH DR
Mailing Address - Street 2:
Mailing Address - City:HASKINS
Mailing Address - State:OH
Mailing Address - Zip Code:43525-9512
Mailing Address - Country:US
Mailing Address - Phone:330-354-1986
Mailing Address - Fax:
Practice Address - Street 1:850 W POE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43402-1219
Practice Address - Country:US
Practice Address - Phone:419-352-7558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJT-0000681174400000X
OHOH-013344225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No174400000XOther Service ProvidersSpecialist