MEDICARE: MRS. BRITTANY HIGHT JELEN 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
1	225700000X	Massage Therapist	12050-146	WI

General Provider Information

NPI Number	:	1285314005
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRITTANY HIGHT JELEN LMT

Provider Business Mailing Address
First Line	:	2823 BRIGHTON DR
Second Line	:
City	:	WAUKESHA
State	:	WI
Zip	:	53188-5975
Country	:	US
Telephone Number	:	262-364-8233
Fax Number	:

Provider Business Practice Location Address
First Line	:	10533 W NATIONAL AVE STE 200
Second Line	:
City	:	WEST ALLIS
State	:	WI
Zip	:	53227-2041
Country	:	US
Telephone Number	:	262-290-5337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2023
Last Update Date	:	07/18/2023

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