Provider Demographics
NPI:1457740938
Name:SKEELS, ALLISON (LMT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SKEELS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1542 W MAPLE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-1392
Mailing Address - Country:US
Mailing Address - Phone:517-266-1011
Mailing Address - Fax:517-266-1011
Practice Address - Street 1:1542 W MAPLE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-1392
Practice Address - Country:US
Practice Address - Phone:517-266-1011
Practice Address - Fax:517-266-1011
Is Sole Proprietor?:No
Enumeration Date:2015-01-21
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI27-3441487225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI27-3441487OtherSTATE OF MICHIGAN