Doctor Name: | MRS. LAURIE WALSH |
NPI Number: | 1992114805 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | B.S., |
License Number: | 5079146 |
Business Practice Address: | 312 E Cherry Cove Ln Round Lake Beach, IL - 600734805 |
Business Phone Number: | 8474458615 |
Business Fax Number: | |
Mailing Address: | 312 E Cherry Cove Ln, ROUND LAKE BEACH |
State: | IL |
Postal Code: | 600734805 |
Phone Number: | 8474458615 |
Fax Number: | |
NPI Enumeration Date: | 08/05/2014 |
NPI Last Update Date: | 08/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 5079146 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy 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. |