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General NPI Number Information
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NPI Number | 1396420444
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Entity Type | Organization
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Legal Business Name | MICHAEL MALECKI ENTERPRISES
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 06/16/2023
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Provider Practice Location Address
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Address Line | 13235 NORTHLINE RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-1070
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Country | US
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Telephone | 734-246-1466
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Fax |
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Provider Business Mailing Address
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Address Line | 32003 PLYMOUTH RD
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City | LIVONIA
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State | MI
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Zip | 48150-1927
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Country | US
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Telephone | 248-470-8300
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL MALECKI
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Credential |
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Telephone | 248-470-8300
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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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