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General NPI Number Information
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NPI Number | 1073321535
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Entity Type | Individual
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Provider Name | CHRISTINA CASS LMT
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Gender | Female
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Dates
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Enumeration Date | 12/30/2024
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Last Update Date | 12/30/2024
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Provider Practice Location Address
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Address Line | N56W39325 WISCONSIN AVE UNIT B
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City | OCONOMOWOC
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State | WI
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Zip | 53066-2192
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Country | US
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Telephone | 262-297-8027
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Fax |
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Provider Business Mailing Address
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Address Line | W1983 MAIN ST
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City | SULLIVAN
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State | WI
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Zip | 53178-9622
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Country | US
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Telephone | 262-297-8027
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 47-14339
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 374K00000X
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Taxonomy Name | Religious Nonmedical Practitioner
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License Number | PWA-4550168
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License Number State | WI
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