Provider Demographics
NPI:1700394491
Name:PRETTO, LINO TUSTEN (LMT)
Entity Type:Individual
Prefix:
First Name:LINO
Middle Name:TUSTEN
Last Name:PRETTO
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1825
Mailing Address - Country:US
Mailing Address - Phone:517-214-8606
Mailing Address - Fax:
Practice Address - Street 1:780 W LAKE LANSING RD STE 400
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-8452
Practice Address - Country:US
Practice Address - Phone:517-575-6362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-16
Last Update Date:2018-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501010578225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist