Organization
ESSENTIAL ENERGY L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA KOMRO L.P.N. (MASSAGE PRACTITIONER)
(715) 495-5984
Entity
Organization
Contact information
Practice address
W2499 COUNTY ROAD T, DURAND, WI 54736-5063
(715) 495-5984
Mailing address
W2499 COUNTY ROAD T, DURAND, WI 54736-5063
(715) 495-5984
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
NONE
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063748051
—
WI
Enumeration date
12/21/2009
Last updated
12/21/2009
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