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Individual

LOREE MAE WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1517 DOCTORS CT, WATERTOWN, WI 53094-4101
(920) 262-2954
Mailing address
1517 DOCTORS CT, WATERTOWN, WI 53094-4101
(920) 262-2954

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3618-146
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3618-146
STATE LICENSING BOARD
WI
Enumeration date
02/25/2021
Last updated
02/25/2021
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