Provider Demographics
NPI:1811275183
Name:STUTZ, ANNA (DPT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:STUTZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:
Other - Last Name:BUDZISZEWSKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:408 HIGUERA ST STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6135
Mailing Address - Country:US
Mailing Address - Phone:805-788-0805
Mailing Address - Fax:805-788-0845
Practice Address - Street 1:7483 E TANQUE VERDE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3477
Practice Address - Country:US
Practice Address - Phone:520-207-7220
Practice Address - Fax:520-207-7109
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT009466225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ153004Medicare PIN