Healthcare Provider Details

I. General information

NPI: 1376956797
Provider Name (Legal Business Name): MILLICENT ASHLEY TRESH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MILLICENT SCHRATZ

II. Dates (important events)

Enumeration Date: 06/03/2014
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

235 WEALTHY ST SE
GRAND RAPIDS MI
49503-5247
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-4610
  • Fax:
Mailing address:
  • Phone: 616-840-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number5101022081
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5101022081
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: