Provider Demographics
NPI:1588230288
Name:MEIS, CASSANDRA LEE
Entity Type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:LEE
Last Name:MEIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:LEE
Other - Last Name:HUNSTAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17266 HWY 23 NE STE 101 PO BOX 99
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:MN
Mailing Address - Zip Code:56273
Mailing Address - Country:US
Mailing Address - Phone:320-354-4793
Mailing Address - Fax:320-354-4585
Practice Address - Street 1:17266 HWY 23 NE STE 101
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:MN
Practice Address - Zip Code:56273
Practice Address - Country:US
Practice Address - Phone:320-354-4793
Practice Address - Fax:320-354-4585
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist