Macie Khan
Individual provider Active NPI Massage Therapist · Woodruff, WI
NPI 1427472000 · NPPES record last updated Feb 18, 2014
Key facts
- NPI
- 1427472000
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 10020-146 (WI)
- Practice address
- 521 Hemlock St
Woodruff, WI 54568-9197 - Phone
- (715) 358-6650
- NPI assigned
- Feb 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
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 |
|---|---|---|---|
| 10020-146 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Country Chiropractic & Wellness LLC | Past | Accepting new patients | |
| North Country Chiropractic, S.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 10020-146 | WI | Yes |
Addresses
Primary practice location
521 Hemlock St
Woodruff, WI 54568-9197
Mailing address
PO Box 2195
Woodruff, WI 54568-2195
Other providers in Woodruff, WI
- Terry Wayne Johnston
- Timothy C. Kakuschke
- Denise A Kearns-Legoo
- Joanne C Kemnitz
- Sara E Keuler
- Vijai Paul Khan
- Kristin King
- Stacey L Klein
- Cassie Elizabeth Kleinhans
- Brook Kmiecik
All providers in Woodruff, 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 18, 2014. 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.