NPI 1063870418

Kelsey Wallace, LMT

Practitioner Massage Therapist Detroit, MI

Practice location

Address: 16500 Joy Rd # 258, Detroit, MI 48228-0632
Phone: (248) 417-5352
Fax: (888) 793-5313

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 7501007544 (MI)

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Registry record

NPI: 1063870418
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Feb 2016
Record last updated: 2 Mar 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.