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General NPI Number Information
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NPI Number | 1881059368
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Entity Type | Individual
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Provider Name | KATHLEEN GIESE LMT, BCTMB
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Gender | Female
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Dates
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Enumeration Date | 12/28/2015
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Last Update Date | 03/23/2022
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Provider Practice Location Address
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Address Line | E19410 MILLER RD
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City | WATERSMEET
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State | MI
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Zip | 49969-9718
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Country | US
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Telephone | 920-948-8836
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Fax |
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Provider Business Mailing Address
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Address Line | E19410 MILLER RD
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City | WATERSMEET
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State | MI
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Zip | 49969-9718
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Country | US
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Telephone | 920-948-8836
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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 | 4377-146
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 7501014193
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License Number State | MI
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