NPI 1548776347

Stephane Marie Smith, LMT

Practitioner Massage Therapist Manitowoc, WI

Practice location

Address: 814 Jay St, Manitowoc, WI 54220-4520
Phone: (920) 686-0328
Mailing address: 731 S 15th St, Manitowoc, WI 54220-3802

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 12531-146 (WI)

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Registry record

NPI: 1548776347
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Dec 2017
Record last updated: 17 Dec 2017

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.