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General NPI Number Information
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NPI Number | 1255098646
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Entity Type | Organization
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Legal Business Name | MUSCLE AND LYMPH MASSAGE THERAPY LLC
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Dates
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Enumeration Date | 11/20/2021
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Last Update Date | 11/20/2021
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Provider Practice Location Address
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Address Line | 12330 JAMES ST STE B60
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City | HOLLAND
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State | MI
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Zip | 49424-8579
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Country | US
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Telephone | 616-294-0063
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Fax |
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Provider Business Mailing Address
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Address Line | 90 W 18TH ST
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City | HOLLAND
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State | MI
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Zip | 49423-4119
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Country | US
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Telephone | 616-294-0063
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Fax |
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Authorized Official
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Title or Position | OWNER/MASSAGE THERAPIST
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Name | MS. KARIANNE JOY BECHTEL-UNEKIS
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Credential | LMT
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Telephone | 616-294-0063
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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