Provider Demographics
NPI:1285129601
Name:BISENIUS, SINDI (MMP, LMT)
Entity type:Individual
Prefix:
First Name:SINDI
Middle Name:
Last Name:BISENIUS
Suffix:
Gender:F
Credentials:MMP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3393 PEACH TREE LN
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52002-2824
Mailing Address - Country:US
Mailing Address - Phone:319-521-3044
Mailing Address - Fax:
Practice Address - Street 1:2728 ASBURY RD
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-2971
Practice Address - Country:US
Practice Address - Phone:563-556-9642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA087987225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist