Individual
HEIDI M KODESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
431 S MAIN ST, RICE LAKE, WI 54868-2241
(715) 736-2338
Mailing address
431 S MAIN ST, RICE LAKE, WI 54868-2241
(715) 736-2338
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2208-046
WI
Other
Enumeration date
08/12/2009
Last updated
08/12/2009
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