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Individual
LAURA C LEVENHAGEN
Active
Individual
LAURA C LEVENHAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
99612-30
WI
163WM1400X
Nurse Massage Therapist (NMT)
2134-146
WI
Other
Enumeration date
12/10/2011
Last updated
12/10/2011
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