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General NPI Number Information
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NPI Number | 1144937509
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Entity Type | Organization
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Legal Business Name | PERSONAL HEALTH MANAGEMENT LLC
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Dates
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Enumeration Date | 11/03/2022
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Last Update Date | 11/03/2022
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Provider Practice Location Address
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Address Line | 35475 FIVE MILE RD RM 2
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City | LIVONIA
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State | MI
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Zip | 48154-2366
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Country | US
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Telephone | 224-829-7522
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Fax |
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Provider Business Mailing Address
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Address Line | 37637 FIVE MILE RD # 110
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City | LIVONIA
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State | MI
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Zip | 48154-1543
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN/OWNER
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Name | MRS. RACHAEL R MCCLELLAN
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Credential | MPH, MS, RDN
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Telephone | 224-829-7522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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