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General NPI Number Information
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NPI Number | 1881037729
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Entity Type | Individual
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Provider Name | NIKKI LYNN ISROW
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Gender | Female
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 06/01/2021
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Provider Practice Location Address
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Address Line | 20726 HALL ROAD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-333-5128
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Fax |
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Provider Business Mailing Address
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Address Line | 20726 HALL ROAD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-333-5128
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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 |
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License Number State |
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