Individual
JERED DION SOLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-5482
Mailing address
2160 GLENCOE HILLS DR APT 10, ANN ARBOR, MI 48108-1022
(620) 757-3327
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501015139
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
597133-10
NATIONAL CERTIFICATION BOARD OF THERAPEUTIC MASSAGE AND BODYWORK (NCBTMB)
—
Enumeration date
04/27/2024
Last updated
04/27/2024
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