Provider Demographics
NPI:1285988972
Name:WUENSTEL, LUCIE (DPT)
Entity type:Individual
Prefix:
First Name:LUCIE
Middle Name:
Last Name:WUENSTEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LUCIE
Other - Middle Name:
Other - Last Name:HORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25241 ELEMENTARY WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34135-7883
Mailing Address - Country:US
Mailing Address - Phone:239-947-4184
Mailing Address - Fax:239-947-4171
Practice Address - Street 1:15620 MCGREGOR BLVD STE 115
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-2528
Practice Address - Country:US
Practice Address - Phone:239-454-6262
Practice Address - Fax:239-454-0350
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-01
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT35830225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist