MANDY M PETERSON (NPI# 1790055192) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790055192 |
| Entity Type | Individual |
| Full Name | MANDY M PETERSON |
| Credential | LMT |
| Practice Address |
1010 N Washington St Janesville WI 53548-1500 |
| Practice Telephone | 6087416799 |
| Practice Fax Number | 6087413838 |
| Mailing Telephone | 6087416799 |
| Mailing Fax Number | 6087413838 |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2012-01-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 10215-146 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871885335 | Mandy M Peterson | Dietitian, Registered | 3325 Pocahontas Rd, Baker City, OR 97814-1464 | 2011-05-03 |
| Street Address |
1010 N WASHINGTON ST |
| City | JANESVILLE |
| State | WI |
| Zip Code | 53548-1500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245222561 | Brandon D Sheetz | Optometrist | 1010 N Washington St, Janesville, WI 53548-1500 | 2005-08-22 |
| 1548822810 | Katherine V Franz | Dietitian, Registered | 1010 N Washington St, Janesville, WI 53548-1500 | 2019-07-08 |
| 1942781786 | Julia C. Green | Dietitian, Registered | 1010 N Washington St, Janesville, WI 53548-1500 | 2018-08-28 |
| 1912415191 | Kelsey J. Kunik | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2018-01-22 |
| 1316468531 | Kristopher James Zainer | Podiatrist | 1010 N Washington St, Janesville, WI 53548-1500 | 2017-06-28 |
| 1467993360 | Nikolina Brkovic | Dietitian, Registered | 1010 N Washington St, Janesville, WI 53548-1500 | 2017-03-13 |
| 1720538291 | Hannah Lee Mulder | Physical Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2016-10-09 |
| 1275993271 | Julie D Bayus | Dietitian, Registered | 1010 N Washington St, Janesville, WI 53548-1500 | 2016-03-03 |
| 1528456571 | Lauri Ann Ashley | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2014-12-29 |
| 1790112985 | Emmie Grace Moss | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2013-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578846010 | Patricia Ann Sheets | Licensed Vocational Nurse | 316 N. Terrace St., Janbesville, WI 53548 | 2011-09-21 |
| 1760658983 | Kristy Kay Prentice Kerl | Dental Hygienist | 121 Jonathon Dr, Janesville, WI 53548 | 2008-05-07 |
| 1316005978 | City of Janesville | Emergency Medical Technician, Paramedic | 18 N Jackson St, Janesville, WI 53548 | 2006-12-05 |
| 1558464115 | Sarah Louise Hessenauer | Social Worker | 17 S. River St, Suite 254, Janesville, WI 53548 | 2006-09-07 |
| 1073548327 | Mary Katherine Cefalu | Registered Nurse | 17 S. River, Suite 254, Janesville, WI 53548 | 2006-07-12 |
| 1699707950 | Gary Lavern Jones | Counselor | 175 River, Suite 254, Janesville, WI 53548 | 2006-07-07 |
| 1295767424 | Michael Stuart Kaye | Clinical Neuropsychologist | 17 S River St Ste 254, Janesville, WI 53548 | 2006-07-07 |
| 1205864055 | Amy Laurie Roy | Counselor | 17 S River Suite 254, Janesville, WI 53548 | 2006-06-29 |
| 1518903566 | Leota I Larson | Psychologist | 17 S River, Suite 254, Janesville, WI 53548 | 2006-06-20 |
| 1760950414 | North Star Chiropractic LLC | Chiropractor | 21 S Jackson St, Ste 160, Janesville, WI 53548 | 2018-11-10 |
| Find all providers in zip 53548 | ||||
| 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 |
|---|---|---|---|---|
| 1396298618 | Jenna Pond | Massage Therapist | 1345 Excalibur Dr, Janesville, WI 53546-1340 | 2016-08-03 |
| 1710119730 | Tanya Kleinhenz | Massage Therapist | 1617 W Court St, Janesville, WI 53548-3503 | 2009-08-10 |
| 1891293304 | Mallory Leonard | Massage Therapist | 4539 Woodgate Dr Ste A, Janesville, WI 53546-8205 | 2018-01-30 |
| 1912415191 | Kelsey J. Kunik | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2018-01-22 |
| 1528456571 | Lauri Ann Ashley | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2014-12-29 |
| 1790112985 | Emmie Grace Moss | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2013-10-02 |
| 1104184712 | Jenny Rebecca Mohr Friedel | Massage Therapist | 1831 W Court St, Janesville, WI 53548-3406 | 2012-05-02 |
| 1558669952 | Tina Nebergall | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2011-03-09 |
| 1770880619 | Kelsey E Kletzien | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2011-02-11 |
| 1043521404 | Dawn Schattschneider | Massage Therapist | 1010 N Washington St, Janesville, WI 53548-1500 | 2010-06-30 |
| Find all providers in JANESVILLE | ||||
| City | JANESVILLE |
| Zip Code | 53548 |
Please comment or provide details below to improve the information on MANDY M PETERSON.
| 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.