Individual
LESLEY R STUCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2400 POPLAR AVE, GUTHRIE CENTER, IA 50115-8878
(641) 747-3225
Mailing address
18317 160TH ST, PERRY, IA 50220-6314
(515) 360-0082
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02550
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
WELLMARK BLUE CROSS BLUE SHIELD
—
Enumeration date
04/19/2021
Last updated
04/19/2021
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