Provider Demographics
NPI:1740050152
Name:WINCEK, ROMELYN M (LMT)
Entity type:Individual
Prefix:
First Name:ROMELYN
Middle Name:M
Last Name:WINCEK
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 1:829 W CLAIREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6102
Mailing Address - Country:US
Mailing Address - Phone:715-833-3505
Mailing Address - Fax:715-833-8515
Practice Address - Street 1:829 W CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6102
Practice Address - Country:US
Practice Address - Phone:715-833-3505
Practice Address - Fax:715-833-8515
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI14266-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist