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NPI Code Detail

MEDICARE: STEPHANIE LYNN WENTZEL

MEDICARE: STEPHANIE LYNN WENTZEL
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
1224Z00000XOccupational Therapy Assistant3792AZ

General Provider Information

NPI Number : 1760643951
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE LYNN WENTZEL
Provider Business Mailing Address
First Line : 1919 W MEDICAL ST
Second Line :
City : TUCSON
State : AZ
Zip : 85704-1133
Country : US
Telephone Number : 520-297-8311
Fax Number : 520-219-7249
Provider Business Practice Location Address
First Line : 1919 W MEDICAL ST
Second Line :
City : TUCSON
State : AZ
Zip : 85704-1133
Country : US
Telephone Number : 520-297-8311
Fax Number : 520-219-7249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 06/19/2008

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Directions to “ STEPHANIE LYNN WENTZEL ” Practice Location

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