Provider Demographics
NPI:1093899536
Name:STURTEVANT, KARI L (PT OCS)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:L
Last Name:STURTEVANT
Suffix:
Gender:F
Credentials:PT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:279 ALTENHOFEN DRIVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913
Mailing Address - Country:US
Mailing Address - Phone:920-738-0671
Mailing Address - Fax:920-738-0773
Practice Address - Street 1:279 ALTENHOFEN DRIVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913
Practice Address - Country:US
Practice Address - Phone:920-738-0671
Practice Address - Fax:920-738-0773
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4811-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist