Individual
RENEE LOUISE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
747 CRESTVIEW LN, FOND DU LAC, WI 54935-6404
(920) 922-8950
Mailing address
747 CRESTVIEW LN, FOND DU LAC, WI 54935-6404
(920) 922-8950
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
103-046
WI
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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