Provider Demographics
NPI:1376588681
Name:LYNCH, STEPHANIE SHIELD (PT DPT)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:SHIELD
Last Name:LYNCH
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Gender:F
Credentials:PT DPT
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Mailing Address - Street 1:3700 N 24TH ST
Mailing Address - Street 2:STE 230
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-6534
Mailing Address - Country:US
Mailing Address - Phone:602-903-4383
Mailing Address - Fax:480-782-5213
Practice Address - Street 1:3700 N 24TH ST
Practice Address - Street 2:STE 230
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6534
Practice Address - Country:US
Practice Address - Phone:602-903-4383
Practice Address - Fax:480-782-5213
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2014-11-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
2255A2300X
AZ9440225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer