Healthcare Provider Details

I. General information

NPI: 1063613412
Provider Name (Legal Business Name): DEANN K. FROLAND RMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DEANN K. FENSKE RMT

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 MIDWAY RD
MENASHA WI
54952-1014
US

IV. Provider business mailing address

4000 N. PROVIDENCE AVENUE
APPLETON WI
54913-8018
US

V. Phone/Fax

Practice location:
  • Phone: 920-727-9878
  • Fax: 920-727-9903
Mailing address:
  • Phone: 920-257-2000
  • Fax: 920-257-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number2287-046
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: