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NPI Code Detail

MEDICARE: MRS. JENNIFER LEE PILLOW-WHITE N.C.T.M.

MEDICARE:  MRS. JENNIFER LEE PILLOW-WHITE  N.C.T.M.
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 Therapist

General Provider Information

NPI Number : 1679613996
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JENNIFER LEE PILLOW-WHITE N.C.T.M.
Provider Business Mailing Address
First Line : 15698 CHESTNUT AVE
Second Line :
City : EASTPOINTE
State : MI
Zip : 48021-2387
Country : US
Telephone Number : 586-215-0729
Fax Number :
Provider Business Practice Location Address
First Line : 6022 W MAPLE RD
Second Line : SUITE 405
City : WEST BLOOMFIELD
State : MI
Zip : 48322-4408
Country : US
Telephone Number : 248-737-8066
Fax Number : 248-737-9093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. JENNIFER LEE PILLOW-WHITE N.C.T.M.” Practice Location

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