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NPI Code Detail

MEDICARE: STEPHEN LEO VENNE P.T.

MEDICARE:   STEPHEN LEO VENNE  P.T.
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
1225100000XPhysical Therapist01713IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
243545OTHERIABC/BS

General Provider Information

NPI Number : 1831278571
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN LEO VENNE P.T.
Provider Business Mailing Address
First Line : 2802 CASTLES GATE DR
Second Line :
City : SIOUX CITY
State : IA
Zip : 51106-7203
Country : US
Telephone Number : 712-266-0707
Fax Number :
Provider Business Practice Location Address
First Line : 2802 CASTLES GATE DR
Second Line :
City : SIOUX CITY
State : IA
Zip : 51106-7203
Country : US
Telephone Number : 712-266-0707
Fax Number : 712-266-0709
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 05/10/2023

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Directions to “ STEPHEN LEO VENNE P.T.” Practice Location

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