Individual
STACEY MOSHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11363 N PORT WASHINGTON ROAD, MEQUON, WI 53092
(262) 833-2060
(262) 833-2061
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4039-19
WI
Other
Enumeration date
02/23/2023
Last updated
01/16/2025
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