Healthcare Provider Details

I. General information

NPI: 1518803444
Provider Name (Legal Business Name): MICHAEL WALSH LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 CENTRAL AVE
DOVER NH
03820-3491
US

IV. Provider business mailing address

660 CENTRAL AVE
DOVER NH
03820-3491
US

V. Phone/Fax

Practice location:
  • Phone: 603-565-0362
  • Fax:
Mailing address:
  • Phone: 603-565-0362
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: