Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derry Petty, LMT

Individual provider Massage Therapist · NPI 1558812214

Derry Petty, LMT is a Massage Therapist in Jackson, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2016
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

See every abbreviation used in this directory →

Practice location Address checks out

337 Oak Grove Ave Apt I
Jackson, MI 49203-1394
Phone: (517) 416-5297
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 7501006216 (MI)

Record details

NPI number1558812214
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorYes
NPI enumeratedOctober 18, 2016
Last updated in NPPESOctober 29, 2016
Mailing address337 Oak Grove Ave Apt I, Jackson, MI 49203-1394

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