Paulette K Gehrke, LMT, NCTM, CPT

Individual provider Active NPI Massage Therapist · Edgerton, WI

NPI 1861661860 · NPPES record last updated Feb 22, 2008

Key facts

NPI
1861661860
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
4051-046 (WI)
Practice address
92 E State Road 59
Suite B
Edgerton, WI 53534-9142
Phone
(608) 931-5246
NPI assigned
Feb 22, 2008
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
4051-046WIMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 4051-046 WI Yes

Addresses

Primary practice location

92 E State Road 59
Suite B
Edgerton, WI 53534-9142

Mailing address

608 Albion Rd
Edgerton, WI 53534-9539
Phone (608) 931-5246

Other providers in Edgerton, WI

All providers in Edgerton, WI · Massage Therapist in Wisconsin

Sources for this page

Verify at the official NPI Registry.