Broadway, Lachetta

Broadway, Lachetta is an sole proprietor health care provider with primary practice located at 520 58Th St Ste 106 , Kenosha WI 53140-4114. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as her primary health care specialty. Broadway, Lachetta can be contacted via phone (262) 551-1317.

Contact Information

Primary practice address
520 58Th St Ste 106 Kenosha WI 53140-4114
Phone: (262) 551-1317
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 12380-146 Wisconsin

Profile Details

NPI number 1982459053
LBN Legal business name Broadway, Lachetta
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 22nd, 2024
Last updated Apr 22nd, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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