Healthcare Provider Details

I. General information

NPI: 1982517538
Provider Name (Legal Business Name): FM-RECOVERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3350 SHELBY ST STE 200
ONTARIO CA
91764-5556
US

IV. Provider business mailing address

3350 SHELBY ST STE 200
ONTARIO CA
91764-5556
US

V. Phone/Fax

Practice location:
  • Phone: 909-721-8554
  • Fax: 909-679-6188
Mailing address:
  • Phone: 909-721-8554
  • Fax: 909-679-6188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: NIKOLAS KYLE MILLER
Title or Position: CEO / HEAD PRACTITIONER
Credential:
Phone: 909-721-8554