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BLUE WATER MEDICAL MASSAGE PLLC NPI 1790280899


NPI Information

NPI: 1790280899
Provider Name: BLUE WATER MEDICAL MASSAGE PLLC
Classification: Massage Therapist - 225700000X
Entity Type: Organization
Address:
1221 BRIARWOOD DR
PORT HURON, MI
ZIP 48060
Phone: (810) 488-0787
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BLUE WATER MEDICAL MASSAGE PLLC is a massage therapist in Port Huron, MI. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. BLUE WATER MEDICAL MASSAGE PLLC NPI is 1790280899. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1221 BRIARWOOD DR
PORT HURON, MI
ZIP 48060-092
Phone: (810) 488-0787
Fax: (810) 294-5356

The provider's authorized official is Joshua Allen Cole .
The authorized official title is Owner and has the following contact phone number (810) 488-0787.

The enumeration date for this NPI number is 3/29/2018 and was last updated on 3/29/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225700000XMassage Therapist7501006219MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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