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Individual

CHRISTINA MARIE LOOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3435 LIVERNOIS RD, TROY, MI 48083-5063
(248) 353-1234
Mailing address
29255 NORTHWESTERN HWY STE 300, SOUTHFIELD, MI 48034-5742
(248) 353-1234

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501005556
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7501005556
LMT
MI
Enumeration date
04/17/2018
Last updated
04/17/2018
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