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NPI Code Detail

MEDICARE: MRS. JACLYN PISKULE MEYERS LMT

MEDICARE: MRS. JACLYN PISKULE MEYERS LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist10857-146WI

General Provider Information

NPI Number : 1164119137
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JACLYN PISKULE MEYERS LMT
Provider Business Mailing Address
First Line : 1114 LILY RD
Second Line :
City : OCONOMOWOC
State : WI
Zip : 53066-2332
Country : US
Telephone Number : 262-409-5045
Fax Number :
Provider Business Practice Location Address
First Line : 1452 GENESEE ST
Second Line :
City : DELAFIELD
State : WI
Zip : 53018-1432
Country : US
Telephone Number : 262-646-5800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2023
Last Update Date : 04/20/2023

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Directions to “ MRS. JACLYN PISKULE MEYERS LMT” Practice Location

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