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General NPI Number Information
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NPI Number | 1891390217
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Entity Type | Individual
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Provider Name | ADAM TRISLER LMT, CHHP, PAC
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Gender | Male
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 57465 N MAIN ST
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City | THREE RIVERS
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State | MI
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Zip | 49093-9799
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Country | US
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Telephone | 574-612-3068
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Fax |
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Provider Business Mailing Address
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Address Line | 30966 RIVERBEND CIR APT 8
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City | OSCEOLA
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State | IN
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Zip | 46561-7635
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Country | US
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Telephone | 574-612-4527
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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 | 7501014033APP20
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License Number State | MI
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