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General NPI Number Information
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NPI Number | 1407570963
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Entity Type | Organization
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Legal Business Name | GARUDA HEALTH LLC
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Dates
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Enumeration Date | 09/28/2022
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 1130 CATALPA DR
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City | BERKLEY
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State | MI
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Zip | 48072-2095
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Country | US
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Telephone | 248-951-8897
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Fax | 248-591-4956
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Provider Business Mailing Address
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Address Line | 1130 CATALPA DR
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City | BERKLEY
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State | MI
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Zip | 48072-2095
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Country | US
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Telephone | 248-951-8897
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Fax | 248-591-4956
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MS. DOMINIQUE D EASLEY
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Credential | RMA
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Telephone | 586-354-1571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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