Provider Demographics
NPI:1376749945
Name:STOEN, REBECCA JEAN (PTA)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JEAN
Last Name:STOEN
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 1:1428 47TH ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:WI
Mailing Address - Zip Code:54082-2311
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:505 W 8TH ST
Practice Address - Street 2:
Practice Address - City:NEW RICHMOND
Practice Address - State:WI
Practice Address - Zip Code:54017-1524
Practice Address - Country:US
Practice Address - Phone:715-246-6851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant