Individual
MRS. BEULAH SUZANNE CARPENTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
700 GENEVA PKWY N, LAKE GENEVA, WI 53147-4594
(262) 249-3500
Mailing address
N1495 BRICK SCHOOL RD, WALWORTH, WI 53184-5708
(262) 607-0817
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4607-146
WI
Other
Enumeration date
03/26/2020
Last updated
03/26/2020
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