Provider Demographics
NPI:1851512891
Name:CRITZ, MICHAEL (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:CRITZ
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 FOREST LANE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042
Mailing Address - Country:US
Mailing Address - Phone:972-272-1633
Mailing Address - Fax:972-487-0192
Practice Address - Street 1:2301 FOREST LANE
Practice Address - Street 2:SUITE 400
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042
Practice Address - Country:US
Practice Address - Phone:972-272-1633
Practice Address - Fax:972-487-0192
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7599225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7599OtherMASSAGE THERAPIST