Provider Demographics
NPI:1790354967
Name:FARKAS, KARI LYNNETTE (LMT)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYNNETTE
Last Name:FARKAS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:LYNNETTE
Other - Last Name:FARKAS-LASICH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:245 S PANSY ST
Mailing Address - Street 2:
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-2744
Mailing Address - Country:US
Mailing Address - Phone:906-202-3851
Mailing Address - Fax:
Practice Address - Street 1:1000 COUNTRY LN STE 400
Practice Address - Street 2:
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-3410
Practice Address - Country:US
Practice Address - Phone:906-486-2000
Practice Address - Fax:906-486-1298
Is Sole Proprietor?:No
Enumeration Date:2021-06-22
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501003153225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist