NPI 1215611231

Shiloh J Besaw, LMT

Practitioner Mechanotherapist Menasha, WI

Practice location

Address: 1478 Kenwood Dr STE 104, Menasha, WI 54952-1161
Phone: (920) 714-9997
Fax: (920) 308-4446
Mailing address: 1477 Kenwood Dr STE 200, Menasha, WI 54952-1160

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence 15373-146 (WI)

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Registry record

NPI: 1215611231
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 Jun 2023
Record last updated: 12 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.