Healthcare Provider Details

I. General information

NPI: 1629341755
Provider Name (Legal Business Name): ASHLEY MARIE STOLTZ OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2012
Last Update Date: 02/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20288 HIGHWAY 15 N STE 100
HUTCHINSON MN
55350-5685
US

IV. Provider business mailing address

712 17TH AVE NW
MANDAN ND
58554-2345
US

V. Phone/Fax

Practice location:
  • Phone: 320-587-2326
  • Fax:
Mailing address:
  • Phone: 701-426-5841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: