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Individual

MS. SHERRY LYN FRASER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RMT

Contact information

Practice address
14 E MAIN ST, WATERTOWN, WI 53094-3746
(920) 253-9494
Mailing address
1416 CENTER ST, WATERTOWN, WI 53098-2014
(920) 253-9494

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2677-046
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2677-046
STATE OF WIS DEPT OF REG AND LICENSING
WI
Enumeration date
04/16/2009
Last updated
04/16/2009
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