Provider Demographics
NPI:1881912905
Name:STEWART, ELIZABETH SUZANN (CPTA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SUZANN
Last Name:STEWART
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 SE 40TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66609-1427
Mailing Address - Country:US
Mailing Address - Phone:785-845-3790
Mailing Address - Fax:
Practice Address - Street 1:141 SE 40TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66609-1427
Practice Address - Country:US
Practice Address - Phone:785-845-3790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-019072251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics