Provider Demographics
NPI:1093460826
Name:BICHLER, MACKENZIE LEIGH (LMT)
Entity Type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:LEIGH
Last Name:BICHLER
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 1:121 FIRST ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BELGIUM
Mailing Address - State:WI
Mailing Address - Zip Code:53004-9318
Mailing Address - Country:US
Mailing Address - Phone:262-416-4256
Mailing Address - Fax:
Practice Address - Street 1:121 FIRST ST APT 4
Practice Address - Street 2:
Practice Address - City:BELGIUM
Practice Address - State:WI
Practice Address - Zip Code:53004-9318
Practice Address - Country:US
Practice Address - Phone:262-416-4256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12597-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist