Individual
MS. STEPHANE MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
814 JAY ST, MANITOWOC, WI 54220-4520
(920) 686-0328
Mailing address
731 S 15TH ST, MANITOWOC, WI 54220-3802
(920) 323-6587
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
12531-146
WI
Other
Enumeration date
12/17/2017
Last updated
12/17/2017
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