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General NPI Number Information
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NPI Number | 1336607167
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Entity Type | Individual
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Provider Name | EMILY KLIK LMT
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Gender | Female
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Dates
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Enumeration Date | 03/11/2019
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Last Update Date | 03/11/2019
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Provider Practice Location Address
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Address Line | 543 A J ALLEN CIR STE A1
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City | WALES
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State | WI
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Zip | 53183-9542
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Country | US
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Telephone | 262-968-2001
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Fax | 262-347-3371
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Provider Business Mailing Address
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Address Line | 543 A J ALLEN CIR STE A1
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City | WALES
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State | WI
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Zip | 53183-9542
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Country | US
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Telephone | 262-968-2001
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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 | 14696-146
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License Number State | WI
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