MEDICARE: STEPHANIE MAUZER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501304135	MI
2	225100000X	Physical Therapist	17235-24	WI

General Provider Information

NPI Number	:	1083592653
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHANIE MAUZER

Provider Business Mailing Address
First Line	:	PO BOX 515
Second Line	:
City	:	BOULDER JUNCTION
State	:	WI
Zip	:	54512-0515
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	454 BAYPARK DR STE 10
Second Line	:
City	:	HOLLAND
State	:	MI
Zip	:	49424
Country	:	US
Telephone Number	:	616-537-6613
Fax Number	:	616-953-8926

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2025
Last Update Date	:	02/02/2026

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Directions to “ STEPHANIE MAUZER ” Practice Location

Language	Start Address	Practice Location

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