Provider Demographics
NPI:1578203295
Name:MAUS, MICHELE R (LMT)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:R
Last Name:MAUS
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 1:1618 MARION RD SE TRLR 104
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-2732
Mailing Address - Country:US
Mailing Address - Phone:651-332-3904
Mailing Address - Fax:
Practice Address - Street 1:847 5TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-2759
Practice Address - Country:US
Practice Address - Phone:507-236-7793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist