Provider Demographics
NPI:1558987297
Name:CHAR, UNKNOWN (LMT)
Entity Type:Individual
Prefix:
First Name:UNKNOWN
Middle Name:
Last Name:CHAR
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:MS
Other - Middle Name:
Other - Last Name:CHAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:3999 HWY 47 N
Mailing Address - Street 2:
Mailing Address - City:RHINELANDER
Mailing Address - State:WI
Mailing Address - Zip Code:54501-8827
Mailing Address - Country:US
Mailing Address - Phone:715-369-7222
Mailing Address - Fax:715-369-7222
Practice Address - Street 1:3999 HWY 47 N
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-8827
Practice Address - Country:US
Practice Address - Phone:715-369-7222
Practice Address - Fax:715-369-7222
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3119-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist