Individual
TI'IA MCKENZIE-DANTITIES FRIISVALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
616 FULTON ST W APT 319, GRAND RAPIDS, MI 49504-6399
(906) 201-7773
Mailing address
616 FULTON ST W APT 319, GRAND RAPIDS, MI 49504-6399
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501016458
MI
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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