Provider Demographics
NPI:1720429954
Name:MCGUIRE, MICHELLE NARDI
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:NARDI
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77101 DOUGLAS TURN ROAD
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:OH
Mailing Address - Zip Code:43973
Mailing Address - Country:US
Mailing Address - Phone:740-491-0791
Mailing Address - Fax:
Practice Address - Street 1:127 EAST SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683
Practice Address - Country:US
Practice Address - Phone:740-491-0791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.004981 N-R225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist