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

Kelsey Wallace, LMT

Individual provider Massage Therapist · NPI 1063870418

Kelsey Wallace, LMT is a Massage Therapist in Detroit, 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.

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Practice location Address checks out

16500 Joy Rd # 258
Detroit, MI 48228-0632
Phone: (248) 417-5352
Fax: (888) 793-5313
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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 7501007544 (MI)

Record details

NPI number1063870418
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorYes
NPI enumeratedFebruary 1, 2016
Last updated in NPPESMarch 2, 2025
Certification dateMarch 2, 2025

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