Provider Demographics
NPI:1205169851
Name:FOLEY, DAVID ONEILL
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ONEILL
Last Name:FOLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1165 ROWENA AVE
Mailing Address - Street 2:
Mailing Address - City:GRASS LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49240-9339
Mailing Address - Country:US
Mailing Address - Phone:734-546-0567
Mailing Address - Fax:
Practice Address - Street 1:1165 ROWENA AVE
Practice Address - Street 2:
Practice Address - City:GRASS LAKE
Practice Address - State:MI
Practice Address - Zip Code:49240
Practice Address - Country:US
Practice Address - Phone:734-546-0567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-15
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI424015-00OtherNATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE AND BODY WORK