Individual
SHILOH J BESAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
1478 KENWOOD DR STE 104, MENASHA, WI 54952-1161
(920) 714-9997
(920) 308-4446
Mailing address
1477 KENWOOD DR STE 200, MENASHA, WI 54952-1160
(920) 714-9997
(920) 308-4446
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
15373-146
WI
Other
Enumeration date
06/12/2023
Last updated
06/12/2023
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