Individual
ASHLEY KNIGHT DISRUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
120 N MAIN ST, OREGON, WI 53575-1405
(608) 515-8125
Mailing address
120 N MAIN ST, OREGON, WI 53575-1405
(608) 515-8125
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13791-146
WI
Other
Enumeration date
10/07/2020
Last updated
10/07/2020
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