Provider Demographics
NPI:1073854477
Name:REX, XUEFEN (LMT)
Entity Type:Individual
Prefix:
First Name:XUEFEN
Middle Name:
Last Name:REX
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1428 E RACINE AVE
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-6462
Mailing Address - Country:US
Mailing Address - Phone:262-832-8888
Mailing Address - Fax:262-806-0028
Practice Address - Street 1:1428 E RACINE AVE
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53186-6462
Practice Address - Country:US
Practice Address - Phone:262-832-8888
Practice Address - Fax:262-806-0028
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-09
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4543146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist