Provider Demographics
NPI:1831123397
Name:STODOLA, DEBRA S (PT)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:STODOLA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:S
Other - Last Name:PAPKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:800 COMPASSIN WAY P O BOX 800
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-0800
Mailing Address - Country:US
Mailing Address - Phone:608-930-8000
Mailing Address - Fax:608-930-7251
Practice Address - Street 1:205 MARITIME DR
Practice Address - Street 2:
Practice Address - City:MANITOWOC
Practice Address - State:WI
Practice Address - Zip Code:54220-6826
Practice Address - Country:US
Practice Address - Phone:920-482-1516
Practice Address - Fax:920-482-1581
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI10119-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI36106800Medicaid
WI001286035OtherMEDICARE