Dolores Wasylik
Individual provider Active NPI Massage Therapist · Deforest, WI
NPI 1356964845 · NPPES record last updated May 19, 2020
Key facts
- NPI
- 1356964845
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 12745-146 (WI)
- Practice address
- 312 E North St
Deforest, WI 53532-1258 - Phone
- (308) 846-3337
- NPI assigned
- May 19, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 12745-146 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bakke Chiropractic Clinic SC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 12745-146 | WI | Yes |
Addresses
Primary practice location
312 E North St
Deforest, WI 53532-1258
Mailing address
312 E North St
Deforest, WI 53532-1258
Phone (308) 846-3337
Other providers in Deforest, WI
- Everett Vang
- Cally Vaughn
- Jennifer A Victor
- Paul Villarreal
- Amanda Wagner
- Morgan Wochinski
- Jennifer Lynn Wyrick
- Shannon Elizabeth Young
All providers in Deforest, 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 May 19, 2020. 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.