Provider Demographics
NPI:1356708481
Name:DEMPSKY, GINGER (LMT)
Entity type:Individual
Prefix:MS
First Name:GINGER
Middle Name:
Last Name:DEMPSKY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 PORLIER STREET
Mailing Address - Street 2:#4
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301
Mailing Address - Country:US
Mailing Address - Phone:715-252-6406
Mailing Address - Fax:
Practice Address - Street 1:1000 NORTH BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:DEPERE
Practice Address - State:WI
Practice Address - Zip Code:54115
Practice Address - Country:US
Practice Address - Phone:715-252-6406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4957-146225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist