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General NPI Number Information
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NPI Number | 1023999828
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Entity Type | Organization
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Legal Business Name | THAI SPA PAVILION 3 LLC
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Dates
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Enumeration Date | 09/09/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 41875 W 11 MILE RD STE 201
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City | NOVI
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State | MI
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Zip | 48375-1877
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Country | US
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Telephone | 734-608-1119
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Fax |
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Provider Business Mailing Address
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Address Line | 39966 PREMIER DR
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City | PLYMOUTH
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State | MI
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Zip | 48170-5760
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Country | US
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Telephone | 248-797-4535
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. PAT SIRI
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Credential |
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Telephone | 248-797-4535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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