Provider Demographics
NPI:1972077998
Name:ZEMEL, REBECCA MICHELLE (LMT)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:MICHELLE
Last Name:ZEMEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:BECKI
Other - Middle Name:
Other - Last Name:ZEMEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:2724 TERRITORIAL RD
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49022-7758
Mailing Address - Country:US
Mailing Address - Phone:269-930-2611
Mailing Address - Fax:
Practice Address - Street 1:815 MAIN ST STE 17
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MI
Practice Address - Zip Code:49085-1473
Practice Address - Country:US
Practice Address - Phone:269-930-2611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-12
Last Update Date:2019-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501011025225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist