MEDICARE: MIKAYLA GRACE WILLIAMS LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	7501014372	MI

General Provider Information

NPI Number	:	1255283594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MIKAYLA GRACE WILLIAMS LMT

Provider Business Mailing Address
First Line	:	1148 HALSTEAD BLVD
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49203-2589
Country	:	US
Telephone Number	:	517-817-8298
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 LAURENCE AVE STE 2
Second Line	:
City	:	JACKSON
State	:	MI
Zip	:	49202-2967
Country	:	US
Telephone Number	:	517-581-2785
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “ MIKAYLA GRACE WILLIAMS LMT” Practice Location

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