Provider Demographics
NPI:1215134333
Name:STUMBRAS, MARTA (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MS
First Name:MARTA
Middle Name:
Last Name:STUMBRAS
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 MORNING STAR CT
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54302-4306
Mailing Address - Country:US
Mailing Address - Phone:920-469-1659
Mailing Address - Fax:
Practice Address - Street 1:2900 CURRY LN
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-5857
Practice Address - Country:US
Practice Address - Phone:920-468-1161
Practice Address - Fax:920-965-2653
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2017-024225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist