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General NPI Number Information
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NPI Number | 1891001095
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Entity Type | Individual
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Provider Name | JENNIFER BARNCARD LMT
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Gender | Female
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 6032 40TH AVE
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City | KENOSHA
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State | WI
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Zip | 53142-7018
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Country | US
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Telephone | 262-957-7743
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Fax |
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Provider Business Mailing Address
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Address Line | 4030 86TH PL
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City | KENOSHA
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State | WI
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Zip | 53142-5028
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Country | US
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Telephone | 262-957-7743
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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 | 3408-046
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License Number State | WI
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