Provider Demographics
NPI:1295048742
Name:STEPHENS, CATHERINE BOSTIGA (PT, MSPT)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:BOSTIGA
Last Name:STEPHENS
Suffix:
Gender:F
Credentials:PT, MSPT
Other - Prefix:MISS
Other - First Name:CATHERINE
Other - Middle Name:ALICE
Other - Last Name:BOSTIGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, MSPT
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-0244
Mailing Address - Country:US
Mailing Address - Phone:606-262-5158
Mailing Address - Fax:267-381-3678
Practice Address - Street 1:84 VERNE HORNE DR
Practice Address - Street 2:APT. 5
Practice Address - City:STAFFORDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41256-9075
Practice Address - Country:US
Practice Address - Phone:606-262-5158
Practice Address - Fax:617-383-6520
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2012-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005770225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist