Macie Khan
Massage Therapist in Woodruff, WI. Individual provider (NPI-1).
NPI number1427472000
StatusActive
Last updated in NPPESFeb 18, 2014
Details
- NPI
- 1427472000
- Entity type
- Individual (NPI-1)
- Name
- Macie Khan
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 18, 2014
- Last updated
- Feb 18, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 10020-146 | WI | Yes |
Practice location
521 Hemlock StWoodruff, WI 54568-9197
Phone 715-358-6650
Mailing address
Po Box 2195Woodruff, WI 54568-2195
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