BRITTANY M. WILDFONG (NPI# 1538455647) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538455647 |
| Entity Type | Individual |
| Full Name | BRITTANY M. WILDFONG |
| Credential | CMT |
| Practice Address |
626 E 8th St Suite 17 Traverse City MI 49686 |
| Practice Telephone | 2319298183 |
| Mailing Telephone | 2319298183 |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2011-06-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
626 E 8TH ST SUITE 17 |
| City | TRAVERSE CITY |
| State | MI |
| Zip Code | 49686 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215119649 | Jill Marie Donberg | Acupuncturist | 626 E 8th St, Suite #17, Traverse City, MI 49686-2504 | 2007-11-27 |
| 1952628497 | Michelle 'shelby' Reynolds | Mechanotherapist | 626 E 8th St, Suite 17, Traverse City, MI 49686-2504 | 2010-04-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245877208 | Jessica Marie Glowacki | Behavior Technician | 935 Hemlock St, Traverse City, MI 49686 | 2019-12-09 |
| 1568011542 | Joanne Kressley | Technician | 1693 Maylane Apt. 104, Traverse City, MI 49686 | 2019-09-11 |
| 1194283846 | Pace North | PACE Provider Organization | 2325 Garfield Road N., Traverse City, MI 49686 | 2019-03-12 |
| 1245749225 | Margaret Anne Goss | Speech-Language Pathologist | 1105 E. Eighth Street, Traverse City, MI 49686 | 2017-09-22 |
| 1467981811 | Joan Joyce Shirilla | Social Worker | 2124 Twin Eagles Dr, Traverse City, MI 49686 | 2017-06-08 |
| 1770028763 | Rehab and Mobility Systems, LLC | Durable Medical Equipment & Medical Supplies | 707 Parsons, Traverse City, MI 49686 | 2016-12-29 |
| 1629511316 | Kaitlyn Grangood | Social Worker | 415 Munson Avenue, Ste 101, Traverse City, MI 49686 | 2016-11-29 |
| 1811441132 | Jeffrey D Goodwin | Counselor | 430 Fair St., Traverse City, MI 49686 | 2016-08-04 |
| 1053779918 | Thomas Osborne | Counselor | 2014 Phelps Rd., Traverse City, MI 49686 | 2016-02-08 |
| 1982079588 | Marsha Lynne Dallas | Counselor | 2240 South Airport Road, Traverse City, MI 49686 | 2015-12-08 |
| Find all providers in zip 49686 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543786 | Elizabeth Marie Pawlowski | Massage Therapist | 745 S Garfield Ave Ste D, Traverse City, MI 49686-3479 | 2019-11-26 |
| 1093275521 | Christine Stalsonburg | Massage Therapist | 812 S Garfield Ave Ste F, Traverse City, MI 49686-3456 | 2019-03-21 |
| 1790283851 | Lisa Louise Kleyps | Massage Therapist | 3337 W. South Airport Road #2, Traverse City, MI 49684 | 2018-01-24 |
| 1922514728 | Hannah Davis | Massage Therapist | 2677 Blue Ridge Ln, Traverse City, MI 49685-8923 | 2017-12-17 |
| 1700248127 | Shannon Murlene Saunders | Massage Therapist | 3337 S Airport Rd W Ste 2, Traverse City, MI 49684-7927 | 2016-03-24 |
| 1932564291 | Kiara Schmittling | Massage Therapist | 3337 South Airport Rd W, Suite 3, Traverse City, MI 49684 | 2015-12-30 |
| 1003298498 | Alesha Kay Flynn | Massage Therapist | 3337 W South Airport Rd, Suite 3, Traverse City, MI 49684 | 2015-06-23 |
| 1083003206 | Maryann Fouch | Massage Therapist | 545 S. Garfield Ave., Suite C, Traverse City, MI 49686 | 2015-01-12 |
| 1881959245 | Bryan Jang Sup Jung | Massage Therapist | 5123 N. Royal Dr., Traverse City, MI 49684 | 2012-07-11 |
| 1124387428 | Laura K Mckinley | Massage Therapist | 3646 Manchester Rd, Traverse City, MI 49686-8115 | 2012-05-08 |
| Find all providers in TRAVERSE CITY | ||||
| City | TRAVERSE CITY |
| Zip Code | 49686 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.