Doctor Name: | MRS. STACEY ANN LUSTILA-SIATS |
NPI Number: | 1285831628 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 6661 |
Business Practice Address: | 1661 Park Ridge Dr Chaska, MN - 553182841 |
Business Phone Number: | 9524032781 |
Business Fax Number: | 9524033979 |
Mailing Address: | 14987 River Oak Ct, SAVAGE |
State: | MN |
Postal Code: | 553785609 |
Phone Number: | 9522262736 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6661 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |