MEDICARE: PHILLIP A JOSLIN 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	7501011199	MI

General Provider Information

NPI Number	:	1780462069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHILLIP A JOSLIN LMT

Provider Business Mailing Address
First Line	:	1446 MICHIGAN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1324
Country	:	US
Telephone Number	:	248-795-9881
Fax Number	:

Provider Business Practice Location Address
First Line	:	1446 MICHIGAN AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-1324
Country	:	US
Telephone Number	:	248-795-9881
Fax Number	:

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

Provider Enumeration Date	:	09/19/2023
Last Update Date	:	09/28/2023

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Directions to “ PHILLIP A JOSLIN LMT” Practice Location

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