Victoria Fay Lickman, MT

Individual provider Active NPI Massage Therapist · Chesaning, MI

NPI 1649500786 · NPPES record last updated Jan 13, 2010

Key facts

NPI
1649500786
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
Practice address
805 W Broad St # 1
Chesaning, MI 48616-1001
Phone
(989) 845-7464
NPI assigned
Jan 13, 2010
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
Credentials
Medical Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X Yes

Addresses

Primary practice location

805 W Broad St # 1
Chesaning, MI 48616-1001

Mailing address

805 W Broad Street, #1
Chesaning, MI 48616-1001
Phone (989) 845-7464

Other providers in Chesaning, MI

All providers in Chesaning, MI · Massage Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.