Provider Demographics
NPI:1922449016
Name:FARRIER, MONICA GRULER (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:GRULER
Last Name:FARRIER
Suffix:
Gender:F
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 1:3773 BOYNE CITY RD
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-9346
Mailing Address - Country:US
Mailing Address - Phone:231-675-5305
Mailing Address - Fax:
Practice Address - Street 1:3773 BOYNE CITY RD
Practice Address - Street 2:
Practice Address - City:BOYNE CITY
Practice Address - State:MI
Practice Address - Zip Code:49712-9346
Practice Address - Country:US
Practice Address - Phone:231-675-5305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501000451225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist