Organization
BLUE WATER MEDICAL MASSAGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA ALLEN COLE (OWNER)
(810) 488-0787
Entity
Organization
Contact information
Practice address
1221 BRIARWOOD DR, PORT HURON, MI 48060-2092
(810) 488-0787
(810) 294-5356
Mailing address
1221 BRIARWOOD DR, PORT HURON, MI 48060-2092
(810) 488-0787
(810) 294-5356
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501006219
MI
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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