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General NPI Number Information
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NPI Number | 1992381933
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Entity Type | Individual
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Provider Name | STEPHEN RHODY
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Gender | Male
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Dates
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Enumeration Date | 03/21/2021
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Last Update Date | 03/21/2021
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Provider Practice Location Address
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Address Line | 6425 NORMANDY LN STE 11
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City | MADISON
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State | WI
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Zip | 53719-1133
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Country | US
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Telephone | 608-421-3958
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Fax |
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Provider Business Mailing Address
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Address Line | 3626 LAKE MENDOTA DR
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City | MADISON
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State | WI
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Zip | 53705-1475
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Country | US
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Telephone | 202-320-9237
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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 | 15368-146
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License Number State | WI
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