Healthcare Provider Details

I. General information

NPI: 1427974872
Provider Name (Legal Business Name): ALISSA GARZONI LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

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

124 PEARL ST STE 305
YPSILANTI MI
48197-2663
US

IV. Provider business mailing address

1252 EVELYN AVE
YPSILANTI MI
48198-6463
US

V. Phone/Fax

Practice location:
  • Phone: 734-794-3634
  • Fax:
Mailing address:
  • Phone: 734-794-3634
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number7501004230
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: