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General NPI Number Information
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NPI Number | 1225921265
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Entity Type | Organization
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Legal Business Name | HOLISTICALLY YOU LLC
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Dates
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Enumeration Date | 05/29/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1971 E BELTLINE AVE NE STE 106-1409
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-7045
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Country | US
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Telephone | 980-317-0318
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Fax |
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Provider Business Mailing Address
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Address Line | 1971 E BELTLINE AVE NE STE 1061409
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-7045
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Country | US
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Telephone | 980-317-0318
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TAMARIS GALLOWAY
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Credential |
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Telephone | 980-483-9262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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