Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath | D5476V | MI |
NPI | 1740553700 |
---|---|
Provider Name | An Lap Ly |
First Address | Sterling Heights, MI 48310-5915 |
Second Address | Sterling Heights, MI 48310-5915 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2012 |
Last Update Date | 21/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
593764-10 | NATIONAL CERTIFICATION BOARD FOR THERAPUETIC MASSAGE & BODYWORK (NCBTMB) (01) | MI |
966552 | ASSOCIATED BODYWORK & MASSAGE PROFESSIONAL (ABMP) (01) | MI |