Provider Demographics
NPI:1952035313
Name:ESSER, ALLAN JAMES (LMT)
Entity Type:Individual
Prefix:
First Name:ALLAN
Middle Name:JAMES
Last Name:ESSER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2486 SPRING ROSE CIR
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:WI
Mailing Address - Zip Code:53593-8922
Mailing Address - Country:US
Mailing Address - Phone:612-801-1365
Mailing Address - Fax:
Practice Address - Street 1:2486 SPRING ROSE CIR
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-8922
Practice Address - Country:US
Practice Address - Phone:612-801-1365
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-12
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15728146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty