Provider Demographics
NPI:1063613412
Name:FROLAND, DEANN K (RMT)
Entity type:Individual
Prefix:
First Name:DEANN
Middle Name:K
Last Name:FROLAND
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:DEANN
Other - Middle Name:K
Other - Last Name:FENSKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RMT
Mailing Address - Street 1:4000 N. PROVIDENCE AVENUE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8018
Mailing Address - Country:US
Mailing Address - Phone:920-257-2000
Mailing Address - Fax:920-257-2004
Practice Address - Street 1:730 MIDWAY RD
Practice Address - Street 2:
Practice Address - City:MENASHA
Practice Address - State:WI
Practice Address - Zip Code:54952-1014
Practice Address - Country:US
Practice Address - Phone:920-727-9878
Practice Address - Fax:920-727-9903
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2287-046225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist