Provider Demographics
NPI:1841812815
Name:HEGNER, PEYTON (OT)
Entity type:Individual
Prefix:
First Name:PEYTON
Middle Name:
Last Name:HEGNER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:PEYTON
Other - Middle Name:
Other - Last Name:STORK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:809 W ROBERTS ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:WI
Mailing Address - Zip Code:54479-9280
Mailing Address - Country:US
Mailing Address - Phone:651-605-5030
Mailing Address - Fax:
Practice Address - Street 1:1000 N OAK AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-5703
Practice Address - Country:US
Practice Address - Phone:715-387-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-13
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist