Provider Demographics
NPI:1730879271
Name:STOECKMANN, ANNA C (PT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:C
Last Name:STOECKMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:C
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:271073 COUNTY ROAD 138
Mailing Address - Street 2:
Mailing Address - City:LURAY
Mailing Address - State:MO
Mailing Address - Zip Code:63453
Mailing Address - Country:US
Mailing Address - Phone:660-341-8785
Mailing Address - Fax:
Practice Address - Street 1:450 E SIGLER AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:MO
Practice Address - Zip Code:63555-1726
Practice Address - Country:US
Practice Address - Phone:660-465-8511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070027361225100000X
MO2023004493225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist