Healthcare Provider Details

I. General information

NPI: 1003408949
Provider Name (Legal Business Name): HEALTH SIMPLIFIED L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2021
Last Update Date: 02/10/2021
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 WASHINGTON ST
OLIVET MI
49076-9462
US

IV. Provider business mailing address

106 WASHINGTON ST
OLIVET MI
49076-9462
US

V. Phone/Fax

Practice location:
  • Phone: 269-280-6010
  • Fax:
Mailing address:
  • Phone: 269-280-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. TANISHA KINGSBURY
Title or Position: OWNER
Credential: ND
Phone: 269-280-6010