Healthcare Provider Details

I. General information

NPI: 1720944150
Provider Name (Legal Business Name): LISA ANNE VELCHANSKY CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/30/2025
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 N MCEWAN ST
CLARE MI
48617-1114
US

IV. Provider business mailing address

7828 FINLEY LAKE AVE
FARWELL MI
48622-9727
US

V. Phone/Fax

Practice location:
  • Phone: 989-386-3838
  • Fax:
Mailing address:
  • Phone: 989-386-3838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7501006558
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: