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Contact Information

KELLY I WATRAS, MT
W6905 PARKVIEW DRIVE
GREENVILLE, WI54942
 Phone: 920-757-9887
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Massage Therapist

225700000X
Indicates primary specialty

NPI Profile & details for KELLY I WATRAS · (Female)

NPI Number 1225557457
Status Active
Credentials MT
Entity Individual
Enumeration date 09/19/2017
Last updated 06/16/2018 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 13809-146
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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