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NPI 1376178095

NPI 1376178095 : SHERRIE L ZANDER LMT : HOLMEN, WI

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General NPI Number Information
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    NPI Number           |    1376178095
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    Entity Type          |    Individual 
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    Provider Name        |    SHERRIE L ZANDER LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/04/2020
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    Last Update Date     |    03/04/2020
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Provider Practice Location Address
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    Address Line         |    1511 S HOLMEN DR 
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    City                 |    HOLMEN
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    State                |    WI
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    Zip                  |    54636-9373
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    Country              |    US
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    Telephone            |    715-498-2498
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    N5802 COTTAGE LN 
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    City                 |    ONALASKA
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    State                |    WI
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    Zip                  |    54650-9607
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    Country              |    US
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    Telephone            |    715-498-2498
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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       |    12959-146
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    License Number State |    WI
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