Springbrook Wellness LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

SPRINGBROOK WELLNESS LLC

Practice address

3715 80TH St
Kenosha, WI 53142-4950

Phone

(262) 358-1975

NPI assigned

Jun 23, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristin E Nieze

Title

Owner/Massage Therapist

Phone

(262) 412-5727

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1437679008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3715 80TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424950",
            "telephone_number": "262-358-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 80TH ST",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531424950",
            "telephone_number": "262-358-1975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRINGBROOK WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NIEZE",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/MASSAGE THERAPIST",
        "authorized_official_telephone_number": "262-412-5727"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.