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General NPI Number Information
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NPI Number | 1538609490
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Entity Type | Organization
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Legal Business Name | ADRIAN MASSAGE THERAPY
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Dates
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Enumeration Date | 02/27/2017
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Last Update Date | 02/27/2017
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Provider Practice Location Address
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Address Line | 1921 US HIGHWAY 223
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City | ADRIAN
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State | MI
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Zip | 49221-1242
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Country | US
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Telephone | 517-263-2900
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Fax | 517-263-9250
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Provider Business Mailing Address
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Address Line | 1921 US HIGHWAY 223
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City | ADRIAN
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State | MI
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Zip | 49221-1242
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Country | US
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Telephone | 517-263-2900
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Fax | 517-263-9250
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Authorized Official
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Title or Position | OWNDER
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Name | DR. CHAD WILLIAM EDISON
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Credential | DC
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Telephone | 517-263-2900
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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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