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NPI Code Detail

MEDICARE: AKIRA MONAY GODFREY LMT

MEDICARE:   AKIRA MONAY GODFREY  LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist7501000192MI

General Provider Information

NPI Number : 1508012162
Entity Type Code : Individual
Provider Name (Legal Business Name) : AKIRA MONAY GODFREY LMT
Provider Business Mailing Address
First Line : 2153 DECKER RD
Second Line : APT 5
City : WALLED LAKE
State : MI
Zip : 48390-2501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2153 DECKER RD
Second Line : APT 5
City : WALLED LAKE
State : MI
Zip : 48390-2501
Country : US
Telephone Number : 248-000-0000
Fax Number : 248-000-0000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2008
Last Update Date : 10/16/2013

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Directions to “ AKIRA MONAY GODFREY LMT” Practice Location

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