MICHELLE DANA WALL (NPI# 1104002716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104002716 |
| Entity Type | Individual |
| Full Name | MICHELLE DANA WALL |
| Practice Address |
4601 Excelsior Blvd 407 Saint Louis Park MN 55416-4960 |
| Practice Telephone | 6122965174 |
| Mailing Telephone | 6122965174 |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2008-01-14 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619195302 | Michelle Deanna Wall | Physician Assistant | 348 N South St, Mount Airy, NC 27030-3532 | 2007-04-20 |
| 1629626171 | Michelle Kristine Wall | Licensed Vocational Nurse | 8001 S Us Highway 75, Sherman, TX 75090-5707 | 2019-08-28 |
| 1366858748 | Michelle M Wall | Physical Therapist | 651 Nicollet Mall Ste 275, Minneapolis, MN 55402 | 2014-07-07 |
| 1730424623 | Michelle Wall | Occupational Therapist | 296 Hamburg Tpke, Wayne, NJ 07470-2150 | 2012-12-03 |
| 1104081447 | Michelle Anne Wall | Dentist | 255 N Gilbert St, Suite C2, Hemet, CA 92543-4066 | 2008-07-25 |
| 1639186349 | Michelle Girouard Wall | Internal Medicine | 300 20th Ave N, 7th Floor, Nashville, TN 37203-2131 | 2006-08-02 |
| 1942258330 | Michelle Wall | Physical Therapist | 200 Newport Center Dr, #213, Newport Beach, CA 92660-7501 | 2006-05-05 |
| Street Address |
4601 EXCELSIOR BLVD 407 |
| City | SAINT LOUIS PARK |
| State | MN |
| Zip Code | 55416-4960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| 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 |
|---|---|---|---|---|
| 1326474842 | Function, LLC | Massage Therapist | 3546 Dakota Ave S, Suite B, Saint Louis Park, MN 55416-2313 | 2013-09-16 |
| 1639352586 | Barbara J Wild | Massage Therapist | 3125 Georgia Ave S, Saint Louis Park, MN 55426-3430 | 2007-12-14 |
| 1629315866 | Theodore James Rick | Massage Therapist | 6009 Wayzata Blvd, Suite 106, Saint Louis Park, MN 55416-1223 | 2013-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417379 | Amanda R Deowdat | Massage Therapist | 7515 Lyndale Ave S, Richfield, MN 55423-4091 | 2020-11-04 |
| 1902405459 | Ferencz Mihaly Vincze Turcean | Massage Therapist | 1703 Snelling Ave N, Falcon Heights, MN 55113-5725 | 2020-10-25 |
| 1447859467 | Amdemichael Retta | Massage Therapist | 1260 Larpenteur Ave W Apt 320, Saint Paul, MN 55113-6324 | 2020-10-21 |
| 1851999478 | John David Haugmo | Massage Therapist | 125 W Lincoln Ave, Fergus Falls, MN 56537-2152 | 2020-10-15 |
| 1720686298 | Jessica Marie Quast | Massage Therapist | 601 Central Ave W Ste 102, Saint Michael, MN 55376-9711 | 2020-10-15 |
| 1861009185 | Miesha Nicole Lewis | Massage Therapist | 3759 Thomas Ave N, Minneapolis, MN 55412-1840 | 2020-09-30 |
| 1588271928 | Cyarra Monique Swanson | Massage Therapist | 2708 Blaisdell Ave Apt B, Minneapolis, MN 55408-1524 | 2020-09-29 |
| 1932716347 | Susan Helen Lundquist | Massage Therapist | 5901 Omaha Ave N Ste 115, Stillwater, MN 55082-6477 | 2020-09-29 |
| 1568078228 | Jasie Barbour | Massage Therapist | 13036 Europa Trl N, Hugo, MN 55038-4410 | 2020-09-18 |
| 1902411648 | Dakota Lee Hain | Massage Therapist | 1121 Jackson St Ne Ste 119, Minneapolis, MN 55413-1597 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS PARK |
| Zip Code | 55416 |
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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.