Healthcare Provider Details
I. General information
NPI: 1588467971
Provider Name (Legal Business Name): TLB ENTERPRISES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2025
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6452 MILLENNIUM STE 170
LANSING MI
48917-6874
US
IV. Provider business mailing address
6211 WINDCHARME AVE
LANSING MI
48917-1280
US
V. Phone/Fax
- Phone: 517-323-4331
- Fax:
- Phone: 517-881-9609
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171400000X |
| Taxonomy | Health & Wellness Coach |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WENDY
Z
BRADLEY
Title or Position: OWNER
Credential:
Phone: 517-881-9609