Provider Demographics
NPI:1144868837
Name:KILCER, MICHELE ANN (MT)
Entity type:Individual
Prefix:MISS
First Name:MICHELE
Middle Name:ANN
Last Name:KILCER
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 UNION ST APT 1
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:12534-2815
Mailing Address - Country:US
Mailing Address - Phone:443-783-5065
Mailing Address - Fax:
Practice Address - Street 1:337 WARREN ST
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2437
Practice Address - Country:US
Practice Address - Phone:443-735-0651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-13
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDM01100225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist