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NPI Code Detail

MEDICARE: BASIA LINDBERG LMT,

MEDICARE:   BASIA  LINDBERG  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 Therapist15808-146WI

General Provider Information

NPI Number : 1184479438
Entity Type Code : Individual
Provider Name (Legal Business Name) : BASIA LINDBERG LMT,
Provider Business Mailing Address
First Line : 6767 W GREENFIELD AVE # LL3
Second Line :
City : MILWAUKEE
State : WI
Zip : 53214-4967
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6767 W GREENFIELD AVE # LL3
Second Line :
City : MILWAUKEE
State : WI
Zip : 53214-4967
Country : US
Telephone Number : 414-274-9621
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2024
Last Update Date : 04/20/2024

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Directions to “ BASIA LINDBERG LMT,” Practice Location

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