Individual
STACEY ANN ERTEL
Active
Individual
STACEY ANN ERTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
3180
OR
172M00000X
Mechanotherapist
Primary
PT-1187
ID
Other
Enumeration date
05/11/2009
Last updated
05/11/2009
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