Individual
MRS. DEANNA LYNN MOOTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
825 WHITING AVE, STEVENS POINT, WI 54481-5246
(715) 346-1615
Mailing address
3541 PLOVER RD, WISCONSIN RAPIDS, WI 54494-2155
(715) 423-5423
(715) 423-1532
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
752-019
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40386900
—
WI
Enumeration date
09/14/2006
Last updated
08/04/2008
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