Provider Demographics
NPI:1003326950
Name:PILLOW, MARIANNE MARGARET
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:MARGARET
Last Name:PILLOW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 S SAGINAW ST STE 1805
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2677
Mailing Address - Country:US
Mailing Address - Phone:810-275-9108
Mailing Address - Fax:
Practice Address - Street 1:4800 S. SAGINAW ST
Practice Address - Street 2:SUITE 1805
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-4850
Practice Address - Country:US
Practice Address - Phone:810-893-6489
Practice Address - Fax:810-213-0283
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501010466225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist