Kimberly Ann Polchlopek, CERTIFIED MASSAGE TH
Individual provider Active NPI Massage Therapist · Allek Park, MI
NPI 1497924203 · NPPES record last updated Feb 26, 2008
Key facts
- NPI
- 1497924203
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 32714600 (MI)
- Practice address
- 7740 Allen Rd
Allek Park, MI 48101 - Phone
- (313) 383-4263
- NPI assigned
- Feb 26, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 32714600 | MI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Body Essentials Therapeutic Massage, LLC | Massage Therapist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 32714600 | MI | Yes |
Addresses
Primary practice location
7740 Allen Rd
Allek Park, MI 48101
Mailing address
6781 Archdale
Detroit, MI 48228
Phone (313) 231-1759
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 26, 2008. 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.