MEDICARE: THERESA MAY

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		MI

General Provider Information

NPI Number	:	1669861720
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THERESA MAY

Provider Business Mailing Address
First Line	:	48774 GRATIOT AVE
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48051-2675
Country	:	US
Telephone Number	:	586-949-5515
Fax Number	:	586-949-0888

Provider Business Practice Location Address
First Line	:	48774 GRATIOT AVE
Second Line	:
City	:	CHESTERFIELD
State	:	MI
Zip	:	48051-2675
Country	:	US
Telephone Number	:	586-949-5515
Fax Number	:	586-949-0888

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

Provider Enumeration Date	:	01/13/2015
Last Update Date	:	01/13/2015

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Directions to “ THERESA MAY ” Practice Location

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