Individual
JAIME L COLLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
5521 CHERRY ST, AVOCA, MI 48006
(810) 300-4178
Mailing address
PO BOX 305, AVOCA, MI 48006-0305
(810) 300-4178
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501007480
MI
Other
Enumeration date
05/21/2019
Last updated
05/21/2019
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