Healthcare Provider Details

I. General information

NPI: 1558265470
Provider Name (Legal Business Name): ALLISSA HORN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5846 MIDLAND RD
FREELAND MI
48623-8707
US

IV. Provider business mailing address

5846 MIDLAND RD
FREELAND MI
48623-8707
US

V. Phone/Fax

Practice location:
  • Phone: 989-573-8575
  • Fax:
Mailing address:
  • Phone: 989-573-8575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7501016245
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: