Individual
STACI LEANN FETHKENHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3930 STADIUM DR, SIOUX CITY, IA 51106-5166
(712) 276-4325
(712) 276-6033
Mailing address
3930 STADIUM DR, SIOUX CITY, IA 51106-5166
(712) 276-4325
(712) 276-6033
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02414
IA
Other
Enumeration date
08/25/2008
Last updated
08/25/2008
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