Individual
MISS LISA ANN SUSALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
344 N SILVER ST, BAD AXE, MI 48413-1539
(989) 269-5031
(989) 269-7904
Mailing address
344 N SILVER ST, BAD AXE, MI 48413-1539
(989) 269-5031
(989) 269-7904
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
MI
Other
Enumeration date
01/26/2007
Last updated
01/26/2009
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