Individual
SANDIE LEE KISTING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1045 N BRISTOL ST, SUN PRAIRIE, WI 53590-1444
(608) 354-9568
Mailing address
1045 N BRISTOL ST, SUN PRAIRIE, WI 53590-1444
(608) 354-9568
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11024-146
WI
Other
Enumeration date
01/13/2021
Last updated
01/13/2021
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