Individual
ALLIESON ELIZABETH MIRSBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
421 CAMELOT DR, FOND DU LAC, WI 54935-8335
(920) 926-8616
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8616
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13321-146
WI
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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