Virginia F Pawlak

Individual provider Active NPI Massage Therapist · Alma, WI

NPI 1013422641 · NPPES record last updated Dec 5, 2017

Key facts

NPI
1013422641
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
14456 (WI)
Practice address
115 S Main St
Alma, WI 54610-7712
Phone
(608) 685-6400
NPI assigned
Dec 5, 2017
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
14456WIMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 14456 WI Yes

Addresses

Primary practice location

115 S Main St
Alma, WI 54610-7712

Mailing address

115 S Main St
Alma, WI 54610-7712
Phone (608) 418-0756

Other providers in Alma, WI

All providers in Alma, WI · Massage Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.