Individual
NICOLE MARIE BUCHWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T., P.T.A.
Contact information
Practice address
49357 PONTIAC TRL, SUITE 104, WIXOM, MI 48393-2068
(248) 445-0788
Mailing address
49357 PONTIAC TRL, SUITE 104, WIXOM, MI 48393-2068
(248) 445-0788
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
5502004244
MI
225700000X
Massage Therapist
Primary
7501001960
MI
Other
Enumeration date
04/15/2015
Last updated
04/15/2015
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