Basic Information
Provider Information
NPI: 1821296575
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HINZMAN
FirstName: STEPHANIE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MPT
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6136 WROTHSTON DR
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432289246
CountryCode: US
TelephoneNumber: 6148702442
FaxNumber:  
Practice Location
Address1: 5471 SCIOTO DARBY RD
Address2:  
City: HILLIARD
State: OH
PostalCode: 430261310
CountryCode: US
TelephoneNumber: 6148767356
FaxNumber: 6145297121
Other Information
ProviderEnumerationDate: 07/04/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: Y
IsOrganizationSubpart:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2251P0200XPT007971OHY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics

No ID Information.


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