Individual
TINA NEBERGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1010 N WASHINGTON ST, JANESVILLE, WI 53548-1500
(608) 741-6799
Mailing address
1010 N WASHINGTON ST, JANESVILLE, WI 53548-1500
(608) 741-6799
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3918-146
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3918-146
WI LIC
WI
Enumeration date
03/09/2011
Last updated
03/09/2011
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