Desiree Greenwood Thomas, L.M.T, L.P.N
Individual provider Active NPI Massage Therapist · Lupton, MI
NPI 1497130488 · NPPES record last updated Jul 20, 2015
Key facts
- NPI
- 1497130488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 7501003939 (MI)
- Practice address
- 3552 Lakeshore Dr
Lupton, MI 48635-9770 - Phone
- (989) 390-1671
- NPI assigned
- Jul 20, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7501003939 | MI | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7501003939 | MI | Yes |
Addresses
Primary practice location
3552 Lakeshore Dr
Lupton, MI 48635-9770
Mailing address
3552 Lakeshore Dr
Lupton, MI 48635-9770
Phone (989) 390-1671
Other providers in Lupton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.