MILDRED V KICK (NPI# 1720553738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720553738 |
| Entity Type | Individual |
| Full Name | MILDRED V KICK |
| Credential | LMT |
| Practice Address |
213 N Black River St Sparta WI 54656-1529 |
| Mailing Address |
Millie Kick N2610 Antony Rd Bangor WI 54614-9315 |
| Practice Telephone | 6084879990 |
| Mailing Telephone | 6084862927 |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 755-146 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
213 N BLACK RIVER ST |
| City | SPARTA |
| State | WI |
| Zip Code | 54656-1529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578019899 | M&t Performance Chiropractic, LLC | Chiropractor | 213 N Black River St, Sparta, WI 54656 | 2016-08-28 |
| 1437792322 | Peak Performance Chiropractic, LLC | Chiropractor | 213 N Black River St, Sparta, WI 54656-1529 | 2019-10-23 |
| 1902300726 | Ethan Karls | Massage Therapist | 213 N Black River St, Sparta, WI 54656-1529 | 2018-03-19 |
| 1043761760 | Megan Karls | Chiropractor | 213 N Black River St, Sparta, WI 54656 | 2016-10-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669929279 | Jennifer Johnson | Physical Therapy Assistant | 14345 County Hwy B, Sparta, WI 54656 | 2016-09-01 |
| 1801223003 | Emily M Nolte | Counselor | 112 S Court St. Room 3000, Sparta, WI 54656 | 2013-10-02 |
| 1518254945 | Therapeutic Home Services | Point of Service | 9484 Festival Avenue, Sparta, WI 54656 | 2011-07-06 |
| 1639488273 | Rebecca Ann Frey | Reflexologist | 5680 Canary Ave, Sparta, WI 54656 | 2010-09-30 |
| 1316276660 | Gary J Korthals | Pharmacist | 201 S. Water St, Sparta, WI 54656 | 2009-12-16 |
| 1689847329 | Donald N. La Force | Hearing Instrument Specialist | 117 West Oak St, Sparta, WI 54656 | 2008-04-02 |
| 1164400503 | Alice M Bachop | Nurse Practitioner | 310 West Main Street, Sparta, WI 54656 | 2006-01-05 |
| 1578540894 | Marc D Tumerman | Family Medicine | 310 West Main St, Sparta, WI 54656 | 2005-12-28 |
| 1003398488 | Ariel Dawn Ferdock | Pharmacist | 310 W Main St, Sparta, WI 54656 | 2018-09-03 |
| 1972001881 | Carmen Alyssa Adams | Physician Assistant | 1111 W Wisconsin St, Sparta, WI 54656 | 2018-01-25 |
| Find all providers in zip 54656 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396379954 | Chad J Needham | Massage Therapist | 101 1/2 S Water St Lowr Unit, Sparta, WI 54656-1722 | 2020-02-23 |
| 1528397155 | Angela Kay Roberts | Massage Therapist | 453 Vista Dr, Sparta, TN 38583-1360 | 2009-12-10 |
| 1245383769 | Barry Ira Gross | Massage Therapist | 90 Sparta Avenue, Sparta, NJ 07871-2030 | 2007-01-19 |
| 1235798265 | Sara Caitlyn Smith | Massage Therapist | 295 N Main St, Sparta, NC 28675-8895 | 2019-06-12 |
| 1902300726 | Ethan Karls | Massage Therapist | 213 N Black River St, Sparta, WI 54656-1529 | 2018-03-19 |
| 1184942476 | Renewal Skin Solutions | Massage Therapist | 453 Vista Dr, Sparta, TN 38583-1360 | 2010-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336749548 | Cindy Ann Pinnow | Massage Therapist | 443 W Main St, Waukesha, WI 53186-4612 | 2020-10-27 |
| 1114526068 | Berevon Tayshawn Wyatt | Massage Therapist | 3510 N Oakland Ave Ste 206, Milwaukee, WI 53211-2746 | 2020-10-21 |
| 1881292035 | Chrysta Beyer | Massage Therapist | 117 W Good Hope Rd, Glendale, WI 53217-3857 | 2020-10-10 |
| 1861099608 | Kaitlin Gelbmann | Massage Therapist | 920 W City Highway 16 Ste A, West Salem, WI 54669-1952 | 2020-10-05 |
| 1447867346 | Evolve Massage LLC | Massage Therapist | 1777 W Main St Ste 106, Sun Prairie, WI 53590-3100 | 2020-09-25 |
| 1174139646 | Rachel Plowman | Massage Therapist | 2911 Blue Aster Blvd, Sun Prairie, WI 53590-4691 | 2020-09-21 |
| 1003422569 | Reeyanana Salet Cha | Massage Therapist | 12201 W Burleigh St Ste 6, Wauwatosa, WI 53222-3102 | 2020-09-21 |
| 1659986453 | Kristin Allie Costello | Massage Therapist | S31w24757 W Sunset Dr, Waukesha, WI 53189-7014 | 2020-09-09 |
| 1073124376 | Maria Victoria Gutierrez | Massage Therapist | 2702 Monroe St Ste 110, Madison, WI 53711-1896 | 2020-08-11 |
| 1699393082 | Laura Lynn Leyh | Massage Therapist | 1907 American Dr Ste B3, Neenah, WI 54956-1236 | 2020-07-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.