Provider Demographics
NPI:1679855571
Name:WILCOX, MICHELLE M (CMT)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:WILCOX
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9370 WESTCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:LAINGSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:48848-9285
Mailing Address - Country:US
Mailing Address - Phone:517-481-6326
Mailing Address - Fax:
Practice Address - Street 1:9370 WESTCHESTER DR
Practice Address - Street 2:
Practice Address - City:LAINGSBURG
Practice Address - State:MI
Practice Address - Zip Code:48848-9285
Practice Address - Country:US
Practice Address - Phone:517-481-6326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist