Michelle Bourassa, LMT
Individual provider Active NPI Massage Therapist · Davison, MI
NPI 1669988820 · NPPES record last updated Feb 11, 2021
Key facts
- NPI
- 1669988820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 7501010287 (MI)
- Practice address
- 3058 N State Rd Ste E
Davison, MI 48423-3508 - Phone
- (810) 652-6315
- Fax
- (810) 652-6213
- NPI assigned
- Dec 22, 2017
- 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 |
|---|---|---|---|
| 7501010287 | MI | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7501010287 | MI | Yes |
Addresses
Primary practice location
3058 N State Rd Ste E
Davison, MI 48423-3508
Mailing address
3058 N State Rd Ste E
Davison, MI 48423-3508
Phone (810) 652-6315
Other providers in Davison, MI
- Bluesky Rehabilitation Therapies
- Boanerges
- Christian Charles Bohlke
- Rachel Booth
- Thomas L Bossi
- Hannah Renee Bradway
- Christina Arlene Brady
- Jake Brejnak
- Brent a Hughes, LLC
- Brianna Dixon, LLPC, PLLC
All providers in Davison, MI · Massage Therapist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 11, 2021. 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.