Doctor Name: | MRS. MICHELE MACK |
NPI Number: | 1861893117 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMT, CPMT |
License Number: | 33.02129080 |
Business Practice Address: | 2179 Stringtown Rd Loft 11 Grove City, OH - 431232989 |
Business Phone Number: | 6148860290 |
Business Fax Number: | |
Mailing Address: | 3850 Powder Ridge Rd, GROVE CITY |
State: | OH |
Postal Code: | 431231292 |
Phone Number: | 6148860290 |
Fax Number: | |
NPI Enumeration Date: | 09/05/2014 |
NPI Last Update Date: | 09/05/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | 33.02129080 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |