Individual
MRS. THEREASA ANNE WIRKUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
124 W BROADWAY, WAUKESHA, WI 53186-4803
(608) 359-9176
Mailing address
W4885 REMER RD, ELKHORN, WI 53121-4353
(608) 359-9176
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13041-146
WI
Other
Enumeration date
10/06/2017
Last updated
02/18/2021
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