Individual
MRS. SANDRA P. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
20079 WEST MAIN STREET, SUITE B, LANNON, WI 53046
(262) 502-4051
(262) 502-4053
Mailing address
P.O. BOX 264, 20079 WEST MAIN STREET SUITE B, LANNON, WI 53046
(262) 502-4051
(262) 502-4053
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
731-046
WI
Other
Enumeration date
12/19/2008
Last updated
12/19/2008
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