Individual
MICHELLE B STACHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1335 S ONEIDA ST, APPLETON, WI 54915-1351
(920) 731-6646
Mailing address
N740 WINDSWAY CT, FREMONT, WI 54940-9184
(920) 470-1165
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
601-019
WI
Other
Enumeration date
06/20/2013
Last updated
06/20/2013
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