Individual
MRS. DIANNE MARIE GOETTL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCR REFLEXOLOGIST
Contact information
Practice address
1610 MAIN STREET, BLOOMER, WI 54724
(715) 568-5173
(715) 568-2673
Mailing address
1610 MAIN STREET, BLOOMER, WI 54724
(715) 568-5173
(715) 568-2673
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
B01208
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9455705
COMMUNITY HEALTH PARTNERSHIP
WI
Enumeration date
08/21/2008
Last updated
08/21/2008
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