Individual
MARIALYCE BRENNAN DORMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1500 N CASALOMA DR STE 411, APPLETON, WI 54913-8219
(920) 954-1446
(920) 882-1061
Mailing address
1500 N CASALOMA DR STE 411, APPLETON, WI 54913-8219
(920) 954-1446
(920) 882-1061
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11511
WI
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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