NPIMap

Colby Marie Robertson

Individual provider Active NPI Massage Therapist · Birch Run, MI

NPI 1710754239 · NPPES record last updated Dec 5, 2023

Key facts

NPI
1710754239
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
7501014546 (MI)
Practice address
11945 Conquest St
Birch Run, MI 48415
Phone
(989) 624-9293
NPI assigned
Dec 5, 2023
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7501014546MIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Chiropractic Inc Current
since Dec 10, 2023		 Accepting new patients
Carroll Chiropractic, Inc Past
since Dec 10, 2023		 Accepting new patients

Locations

11945 Conquest St
Birch Run, MI 48415
Phone (989) 624-9293

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 7501014546 MI Yes

Addresses

Primary practice location

11945 Conquest St
Birch Run, MI 48415

Mailing address

4635 Rathbun Rd
Birch Run, MI 48415
Phone (269) 506-8748

Other providers in Birch Run, MI

All providers in Birch Run, MI · Massage Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.