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General NPI Number Information
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NPI Number | 1417122243
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Entity Type | Individual
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Provider Name | MARLENE S. EMPCKE LMT, MMP, CS1
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Gender | Female
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 136 W WATER ST
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City | OAK HARBOR
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State | OH
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Zip | 43449-2303
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Country | US
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Telephone | 419-898-3096
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Fax |
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Provider Business Mailing Address
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Address Line | 9138 W BLOOM RD
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City | OAK HARBOR
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State | OH
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Zip | 43449-9650
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Country | US
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Telephone | 419-898-0326
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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 | 33.012429
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License Number State | OH
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