Most Relevant Information
Provider Data
| NPI Number: | 1003417247 |
| Provider Name: | MELISSA WHITAKER LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 7501007455 |
Most Important Dates
| Enumeration Date: | 11/04/2020 |
| Last Updated: | 11/04/2020 |
Provider Practice Location
17439 FORT ST
RIVERVIEW
MI
481936630
Practice Location Phone/Fax
| Phone: | 7343657101 |
| Fax: | 7345746006 |
Provider Mailing Location
17439 FORT ST
RIVERVIEW
MI
481936630
Provider Mailing Phone/Fax
| Phone: | 7343657101 |
| Fax: | 7345746006 |