Healthcare Provider Details

I. General information

NPI: 1942431945
Provider Name (Legal Business Name): INNA FORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2009
Last Update Date: 08/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E COLUMBIA AVE
BATTLE CREEK MI
49014-5412
US

IV. Provider business mailing address

501 E COLUMBIA AVE
BATTLE CREEK MI
49014-5412
US

V. Phone/Fax

Practice location:
  • Phone: 269-962-2836
  • Fax:
Mailing address:
  • Phone: 269-962-2836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: