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Individual

DEBRA S. STODOLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
205 MARITIME DR, MANITOWOC, WI 54220-6826
(920) 482-1516
(920) 482-1581
Mailing address
800 COMPASSIN WAY P O BOX 800, DODGEVILLE, WI 53533-0800
(608) 930-8000
(608) 930-7251

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10119-024
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001286035
MEDICARE
WI
05
36106800
WI
Enumeration date
07/10/2006
Last updated
02/05/2017
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