Individual
MS. IRAS HUMPHREYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10705 N LINDEN RD, HAYWARD, WI 54843-4047
(715) 634-2560
Mailing address
10705 N LINDEN RD, HAYWARD, WI 54843-4047
(715) 634-2560
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4752046
MASSAGE THERAPIST
WI
Enumeration date
12/04/2009
Last updated
12/04/2009
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