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Individual

TREECE MARY KAMPMEYER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MASSAGE THERAPIST

Contact information

Practice address
311 RAMSEY ST, SAINT PAUL, MN 55102-2323
(651) 222-5552
Mailing address
1851 COVINGTON LN, EAGAN, MN 55122-2682
(651) 905-9053

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
83851
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3188517
STATE TAX IDENTIFICATION
MN
01
406311
ABMP
Enumeration date
12/04/2006
Last updated
07/08/2007
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