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Individual

TERI SUE KATHMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1812 24TH AVE W STE 102, SPENCER, IA 51301-2661
(515) 320-4065
Mailing address
2915 150TH AVE, EVERLY, IA 51338-7571
(515) 320-4065

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4939
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4939
IOWA MASSAGE LICENSE
IA
Enumeration date
08/25/2021
Last updated
08/26/2021
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