Individual provider · Type 1 NPI

Lisa Marie Wicklund, LMT

Massage Therapist · Blaine, MN

NPI number 1609304476 Active

Practice location

9140 Baltimore St NE Ste 140-5
Blaine, MN 55449-4382

Call (612) 481-9718 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X17-07455 (MN)

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.

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About NPI 1609304476

Lisa Marie Wicklund, LMT's National Provider Identifier is 1609304476, issued on May 24, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Blaine, MN. The record was last updated on Jul 21, 2022.