Healthcare Provider Details

I. General information

NPI: 1538327564
Provider Name (Legal Business Name): CHARLOTTE R STECKELBERG OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 02/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 COMPASSION WAY
DODGEVILLE WI
53533-1956
US

IV. Provider business mailing address

S10629 WILSON CREEK RD
SPRING GREEN WI
53588-9162
US

V. Phone/Fax

Practice location:
  • Phone: 608-930-7147
  • Fax:
Mailing address:
  • Phone: 608-546-2025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XE1200X
TaxonomyErgonomics Occupational Therapist
License Number2033-026
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: