Churchill, Stacey Joyce
Churchill, Stacey Joyce is an sole proprietor health care provider with primary practice located at 1600 Hunt Trace Blvd , Clermont FL 34711-5184. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Churchill, Stacey Joyce can be contacted via phone (352) 394-5549.Contact Information
Primary practice address
1600 Hunt Trace Blvd
Clermont FL 34711-5184
Phone: (352) 394-5549
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 11349 | North Carolina |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT26441 | Florida |
Profile Details
| NPI number | 1932384013 |
|---|---|
| LBN Legal business name | Churchill, Stacey Joyce |
| Credentials | Master of Physical Therapy (MPT) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 8th, 2008 |
| Last updated | Sep 30th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932384013 | NPPES |
| North Carolina | MEDICAID | 7212335 | |
| North Carolina | Other | 068VV |
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