Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | WI |
NPI | 1013536598 |
---|---|
Provider Name | Jennifer Ann Zink |
First Address | Neillsville, WI 54456-1925 |
Second Address | Neillsville, WI 54456-1925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2020 |
Last Update Date | 14/04/2020 |