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KELSEY WALLACE LMT
NPI 1063870418
Massage Therapist in Detroit, MI

Active since February 01, 2016
16500 JOY RD # 258, DETROIT, MI 48228(248) 417-5352(888) 793-5313 Get Directions Write a Review

NPPES record last updated: March 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 2, 2025, Feb 1, 2016 (2 updates tracked since 2016).

About Kelsey Wallace Lmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELSEY WALLACE LMT (NPI 1063870418) is an individual massage therapist in Detroit, Michigan, licensed in Michigan (7501007544) and active in the NPI registry since February 2016.

NPPES Registry Identity

NPI1063870418
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameKELSEY WALLACECredential: LMT
Location Address16500 JOY RD # 258Detroit, MI 48228-0632
Mailing Address16500 Joy Rd # 258Detroit, MI 48228-0632 · (248) 417-5352 · Fax (888) 793-5313
Phone(248) 417-5352
Fax(888) 793-5313
Sole ProprietorYes
Enumeration DateFebruary 1, 2016
Last NPPES UpdateMarch 2, 20252 updates tracked since enumeration
NPPES CertifiedMarch 2, 2025
✔ NPI 1063870418 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in MI · 7501007544
Definition
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.
16500 JOY RD # 258, Detroit, MI 48228
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsey Wallace's NPI number?

The NPI number for Kelsey Wallace is 1063870418. It was assigned to this individual provider in the NPPES registry on February 1, 2016.

Where is Kelsey Wallace located?

Kelsey Wallace practices at 16500 Joy Rd # 258, Detroit, MI 48228. The listed phone number is (248) 417-5352.

What is Kelsey Wallace's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Kelsey Wallace was last updated on March 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.