Provider Demographics
NPI:1285165522
Name:MAAS, DYLANA (LMT,BCTMB)
Entity type:Individual
Prefix:
First Name:DYLANA
Middle Name:
Last Name:MAAS
Suffix:
Gender:F
Credentials:LMT,BCTMB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 WATER ST
Mailing Address - Street 2:
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-2971
Mailing Address - Country:US
Mailing Address - Phone:715-544-2445
Mailing Address - Fax:
Practice Address - Street 1:2413 POST RD
Practice Address - Street 2:SUITE A
Practice Address - City:PLOVER
Practice Address - State:WI
Practice Address - Zip Code:54467-2971
Practice Address - Country:US
Practice Address - Phone:715-544-2445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist