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General NPI Number Information
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NPI Number | 1386501815
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Entity Type | Individual
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Provider Name | KYRIE EDWARDS LICENSED MASSAGE THE
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Gender | Female
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Dates
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Enumeration Date | 01/07/2026
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Last Update Date | 01/07/2026
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Provider Practice Location Address
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Address Line | 307 S FARWELL ST STE 203
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City | EAU CLAIRE
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State | WI
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Zip | 54701-1701
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Country | US
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Telephone | 715-797-0707
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Fax |
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Provider Business Mailing Address
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Address Line | W1459 265TH AVE
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City | PLUM CITY
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State | WI
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Zip | 54761-8803
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Country | US
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Telephone | 715-797-0707
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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 | 15086146
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License Number State | WI
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