Individual
JUSTIN L STAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
111 RIVERFRONT, WINONA, MN 55987-3456
(507) 454-8700
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7647
MN
Other
Enumeration date
05/17/2006
Last updated
07/08/2007
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