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Ms. Diane Therese Willis, LMT
Massage Therapist in Pewaukee, Wisconsin
NPI 1144857343

Diane Therese Willis is a Massage Therapist based in Pewaukee, WI. Diane Therese Willis practices in Pewaukee, WI and has the professional credentials of LMT. The NPI Number for Diane Therese Willis is 1144857343 and holds a License No. 12802-146 (Wisconsin).

The current practice location address for Diane Therese Willis is 580 Foxtail Dr Apt 101, Pewaukee, WI and can be reached out via phone at 262-719-4349.

Location: 580 Foxtail Dr Apt 101, Pewaukee, WI, 53072-2492
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144857343
Provider Name
Diane Therese Willis
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
580 Foxtail Dr Apt 101, Pewaukee, WI, 53072-2492
Phone Number
262-719-4349
Fax Number
Provider Enumeration Date
03/26/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
580 Foxtail Dr Apt 101
City
Pewaukee
State
Wisconsin
Zip
53072-2492
Phone Number
262-719-4349
Fax Number
person
Provider Business Mailing Address Details
Address
580 Foxtail Dr Apt 101
City
Pewaukee
State
Wisconsin
Zip
53072-2492
Phone Number
262-719-4349
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
12802-146 (Wisconsin)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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