Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist |
NPI | 1013585249 |
---|---|
Provider Name | Kelsey M Rau |
First Address | Lansing, MI 48912-3825 |
Second Address | East Lansing, MI 48823-8444 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2021 |
Last Update Date | 14/06/2021 |