Individual
MS. CHARLENE FAY STIPES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
313 STOUGHTON RD, EDGERTON, WI 53534-1132
(608) 884-3441
Mailing address
9673 N BLACKHAWK DR, EDGERTON, WI 53534-8613
(608) 884-8996
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1061 - 019
WI
Other
Enumeration date
01/03/2007
Last updated
07/08/2007
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