Provider Demographics
NPI:1578842233
Name:STEGMAN, BRANDI B (CPTA)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:B
Last Name:STEGMAN
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:KS
Mailing Address - Zip Code:67108-9408
Mailing Address - Country:US
Mailing Address - Phone:316-667-2431
Mailing Address - Fax:316-661-2352
Practice Address - Street 1:704 E MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:KS
Practice Address - Zip Code:67108-9408
Practice Address - Country:US
Practice Address - Phone:316-667-2431
Practice Address - Fax:316-661-2352
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-12
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1402224225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant