Jacob Charles Parenteau, LMT
Individual provider Active NPI Massage Therapist · Caledonia, WI
NPI 1326745563 · NPPES record last updated Feb 8, 2023
Key facts
- NPI
- 1326745563
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 14809 (WI)
- Practice address
- 5401 Douglas Ave
Suite# a
Caledonia, WI 53402 - Phone
- (262) 681-8829
- Fax
- (262) 681-8830
- NPI assigned
- Feb 8, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14809 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caledonia Chiropractic Clinic, SC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 14809 | WI | Yes |
Addresses
Primary practice location
5401 Douglas Ave
Suite# a
Caledonia, WI 53402
Mailing address
2900 Crossridge Dr
Racine, WI 53405
Phone (262) 909-8043
Other providers in Caledonia, WI
- Ashley Amanda Lawler
- LT Total Health
- Massage by K
- Leah McGowen
- Tatum Nehls
- Marissa Jane Parkin
- Julie Anne Pignotti
- Paula Pintar
- Leah E Polack
- Rebecca Lynn Rabe
All providers in Caledonia, WI · Massage Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.