Healthcare Provider Details

I. General information

NPI: 1952994212
Provider Name (Legal Business Name): HARMONY RESTORATIVE PAIN AND AESTHETICS SERVICES, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2021
Last Update Date: 02/18/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 ELWOOD RD
LANSING MI
48917-2070
US

IV. Provider business mailing address

926 ELWOOD RD
LANSING MI
48917-2070
US

V. Phone/Fax

Practice location:
  • Phone: 517-483-2903
  • Fax: 517-574-5169
Mailing address:
  • Phone: 517-483-2903
  • Fax: 517-574-5169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LOUIS E WULFEKUHLER
Title or Position: CEO
Credential:
Phone: 517-483-2903