Individual
JENNY LOU KUSKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
1477 KENWOOD DR, MENASHA, WI 54952-1160
(920) 810-0514
Mailing address
1477 KENWOOD DR, MENASHA, WI 54952-1160
(920) 810-0514
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
155-146
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
155-146
MASSAGE THERAPIST
WI
Enumeration date
05/25/2012
Last updated
05/25/2012
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