Provider Demographics
NPI:1316256613
Name:STAMMEN, JULIE E (PTA)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:E
Last Name:STAMMEN
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 OPAL DR
Mailing Address - Street 2:
Mailing Address - City:COLDWATER
Mailing Address - State:OH
Mailing Address - Zip Code:45828-1058
Mailing Address - Country:US
Mailing Address - Phone:419-678-8604
Mailing Address - Fax:
Practice Address - Street 1:806 OPAL DR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:OH
Practice Address - Zip Code:45828-1058
Practice Address - Country:US
Practice Address - Phone:419-678-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02891225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant