Provider Demographics
NPI:1518380682
Name:STAINBROOK, ABBY JO
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:JO
Last Name:STAINBROOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:JO
Other - Last Name:TEN NAPEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 921
Mailing Address - Street 2:
Mailing Address - City:LE MARS
Mailing Address - State:IA
Mailing Address - Zip Code:51031-0921
Mailing Address - Country:US
Mailing Address - Phone:712-546-1718
Mailing Address - Fax:712-546-1770
Practice Address - Street 1:789 HOLTON DR
Practice Address - Street 2:
Practice Address - City:LE MARS
Practice Address - State:IA
Practice Address - Zip Code:51031-3757
Practice Address - Country:US
Practice Address - Phone:712-546-1718
Practice Address - Fax:712-546-1770
Is Sole Proprietor?:No
Enumeration Date:2014-01-27
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA004551225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist