Individual
LEE ANN LAES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
681 BAETEN RD, SUITE C, GREEN BAY, WI 54304-4860
(920) 857-3056
Mailing address
681 BAETEN RD., SUITE C, GREEN BAY, WI 54304
(920) 857-3056
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10590-146
WI
Other
Enumeration date
10/14/2014
Last updated
10/14/2014
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