Healthcare Provider Details

I. General information

NPI: 1558287946
Provider Name (Legal Business Name): MRS. KATELYNN ROSE VOGLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N MITCHELL ST
CADILLAC MI
49601-1839
US

IV. Provider business mailing address

13874 21 MILE RD
TUSTIN MI
49688-8596
US

V. Phone/Fax

Practice location:
  • Phone: 530-616-9228
  • Fax:
Mailing address:
  • Phone: 530-616-9228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7501015895
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: