Provider Demographics
NPI:1750770475
Name:MILEWSKI, ANNE G (LMT)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:G
Last Name:MILEWSKI
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 1:1260 N HUBBARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MI
Mailing Address - Zip Code:48742-9231
Mailing Address - Country:US
Mailing Address - Phone:989-312-5772
Mailing Address - Fax:
Practice Address - Street 1:1260 N HUBBARD LAKE RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MI
Practice Address - Zip Code:48742-9231
Practice Address - Country:US
Practice Address - Phone:989-312-5772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-19
Last Update Date:2015-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501001756225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist