Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 693024 | WI |
NPI | 1093911315 |
---|---|
Provider Name | Ms. Patricia Kay Stegeman-Frank |
First Address | Green Bay, WI 54304-2019 |
Second Address | Green Bay, WI 54301-2878 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2007 |
Last Update Date | 08/07/2007 |