Basic Information
| Provider Information | |||||||||
| NPI: | 1588988430 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PEPPLER | ||||||||
| FirstName: | SUMMER | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | N2091 STONE CLIFF DR | ||||||||
| Address2: | |||||||||
| City: | VULCAN | ||||||||
| State: | MI | ||||||||
| PostalCode: | 498928745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9065635744 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5778 CHAPIN ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | WI | ||||||||
| PostalCode: | 541219443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7156963605 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/22/2010 | ||||||||
| LastUpdateDate: | 03/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | 1657 | WI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | 225200000X | 5502001867 | MI | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.