Provider Demographics
NPI:1689035453
Name:BILLER, TERESA (LMT)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:
Last Name:BILLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8575 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:MECOSTA
Mailing Address - State:MI
Mailing Address - Zip Code:49332-9754
Mailing Address - Country:US
Mailing Address - Phone:231-250-8988
Mailing Address - Fax:
Practice Address - Street 1:8575 11 MILE RD
Practice Address - Street 2:
Practice Address - City:MECOSTA
Practice Address - State:MI
Practice Address - Zip Code:49332-9754
Practice Address - Country:US
Practice Address - Phone:231-250-8988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501002472225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist