Lietke, Jacquelyn
Lietke, Jacquelyn is an sole proprietor health care provider with primary practice located at 3120 South Ave Ste 105 , La Crosse WI 54601-6720. 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. Lietke, Jacquelyn can be contacted via phone (608) 317-5788.Contact Information
Primary practice address
3120 South Ave Ste 105
La Crosse WI 54601-6720
Phone: (608) 317-5788
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | Wisconsin | |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist | 225700000X | 10111-146 | Wisconsin |
Profile Details
| NPI number | 1225676083 |
|---|---|
| LBN Legal business name | Lietke, Jacquelyn |
| Credentials | LMT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 11th, 2019 |
| Last updated | Dec 11th, 2019 - about 6 years 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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