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General NPI Number Information
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NPI Number | 1457297913
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Entity Type | Individual
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Provider Name | CALISTA JEWEL LAYLE
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Gender | Female
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 4370 FASHION SQUARE BLVD
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City | SAGINAW
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State | MI
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Zip | 48603-5221
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Country | US
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Telephone | 989-988-3740
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 N CATHERINE ST
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City | BAY CITY
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State | MI
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Zip | 48706-3612
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7501017482
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License Number State | MI
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