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Wyatt Richard Johnson, LMT
Massage Therapist in Milwaukee, Wisconsin
NPI 1194410100

Wyatt Richard Johnson is a Massage Therapist based in Milwaukee, WI. Wyatt Richard Johnson practices in Milwaukee, WI and has the professional credentials of LMT. The NPI Number for Wyatt Richard Johnson is 1194410100 and holds a License No. 15697-146 (Wisconsin).

The current practice location address for Wyatt Richard Johnson is 5261 N Port Washington Rd Ste 101, Milwaukee, WI and can be reached out via phone at 414-332-6001.

Location: 5261 N Port Washington Rd Ste 101, Milwaukee, WI, 53211-3756
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194410100
Provider Name
Wyatt Richard Johnson
Credential
LMT
Provider Entity Type
Individual
Gender
Male
Address
5261 N Port Washington Rd Ste 101, Milwaukee, WI, 53211-3756
Phone Number
414-332-6001
Fax Number
Provider Enumeration Date
04/06/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
5261 N Port Washington Rd Ste 101
City
Milwaukee
State
Wisconsin
Zip
53217-4903
Phone Number
414-332-6001
Fax Number
person
Provider Business Mailing Address Details
Address
5261 N Port Washington Rd Ste 101
City
Milwaukee
State
Wisconsin
Zip
53217-4903
Phone Number
414-332-6001
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
15697-146 (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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