Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7501010466 | MI |
NPI | 1003326950 |
---|---|
Provider Name | Marianne Margaret Pillow |
First Address | Flint, MI 48507-2677 |
Second Address | Flint, MI 48507-4850 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2017 |
Last Update Date | 05/10/2017 |