Healthcare Provider Details
I. General information
NPI: 1659748168
Provider Name (Legal Business Name): WHOLE BEING THERAPY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2015
Last Update Date: 03/29/2023
Certification Date: 03/29/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2154 COMMONS PKWY
OKEMOS MI
48864-3986
US
IV. Provider business mailing address
2154 COMMONS PKWY
OKEMOS MI
48864-3986
US
V. Phone/Fax
- Phone: 517-657-7906
- Fax: 517-657-7908
- Phone: 517-657-7906
- Fax: 517-657-7908
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204D00000X |
| Taxonomy | Neuromusculoskeletal Medicine & OMM Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 5101015691 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARA
M
WINKLER
Title or Position: PHYSICIAN/OWNER
Credential: DO
Phone: 517-657-7906