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General NPI Number Information
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NPI Number | 1881997880
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Entity Type | Individual
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Provider Name | VIVIAN MICHAUD L.D.T.
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Gender | Female
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Dates
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Enumeration Date | 12/13/2010
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 11288 SAINT PETERS RD
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City | BROOKVILLE
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State | IN
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Zip | 47012-9125
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Country | US
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Telephone | 812-623-2106
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Fax |
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Provider Business Mailing Address
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Address Line | 33 W WALNUT ST
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City | OXFORD
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State | OH
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Zip | 45056-1747
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Country | US
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Telephone | 800-884-6973
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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 | IN
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