Provider Demographics
NPI:1265677991
Name:STEBLER, ISABELLE QUIROZ (PTA)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:QUIROZ
Last Name:STEBLER
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:MESCALERO
Mailing Address - State:NM
Mailing Address - Zip Code:88340-0359
Mailing Address - Country:US
Mailing Address - Phone:505-464-4802
Mailing Address - Fax:505-464-4825
Practice Address - Street 1:1211 8TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-5808
Practice Address - Country:US
Practice Address - Phone:505-464-4802
Practice Address - Fax:505-464-4825
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-250225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant