Provider Demographics
NPI:1578871463
Name:STACH, ANNA L (CPTA)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:L
Last Name:STACH
Suffix:
Gender:F
Credentials:CPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:3301 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1427
Mailing Address - Country:US
Mailing Address - Phone:620-474-1009
Mailing Address - Fax:
Practice Address - Street 1:108 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:INMAN
Practice Address - State:KS
Practice Address - Zip Code:67546-8016
Practice Address - Country:US
Practice Address - Phone:620-585-6411
Practice Address - Fax:620-585-6504
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-01894225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant