Wicklund, Lisa Marie

Wicklund, Lisa Marie is an sole proprietor health care provider with primary practice located at 9140 Baltimore St Ne Ste 140-5 , Blaine MN 55449-4382. 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. Wicklund, Lisa Marie can be contacted via phone (612) 481-9718.

Contact Information

Primary practice address
9140 Baltimore St Ne Ste 140-5 Blaine MN 55449-4382
Phone: (612) 481-9718
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 17-07455 Minnesota

Profile Details

NPI number 1609304476
LBN Legal business name Wicklund, Lisa Marie
Credentials LMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 24th, 2017
Last updated Jul 21st, 2022 - about 3 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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