MEDICARE: HEATHER LYNN KITZMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	14570-146	WI

General Provider Information

NPI Number	:	1336012673
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LYNN KITZMAN

Provider Business Mailing Address
First Line	:	1216 BUENA VISTA DR # DT
Second Line	:
City	:	BLACK RIVER FALLS
State	:	WI
Zip	:	54615-5983
Country	:	US
Telephone Number	:	715-299-8137
Fax Number	:

Provider Business Practice Location Address
First Line	:	1216 BUENA VISTA DR # DT
Second Line	:
City	:	BLACK RIVER FALLS
State	:	WI
Zip	:	54615-5983
Country	:	US
Telephone Number	:	715-299-8137
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	10/24/2025

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Directions to “ HEATHER LYNN KITZMAN ” Practice Location

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