Basic Information
| Provider Information | |||||||||
| NPI: | 1386895365 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STUTZMAN | ||||||||
| FirstName: | LORA | ||||||||
| MiddleName: | JEAN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8601 VETERANS HWY | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | MILLERSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211081547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4109872162 | ||||||||
| FaxNumber: | 4109872975 | ||||||||
| Practice Location | |||||||||
| Address1: | 3179 BRAVERTON ST | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | EDGEWATER | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210372665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2027826371 | ||||||||
| FaxNumber: | 4109568038 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/08/2008 | ||||||||
| LastUpdateDate: | 07/12/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 22605 | MD | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.