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General NPI Number Information
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NPI Number | 1609682368
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Entity Type | Organization
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Legal Business Name | MITTEN HEALTH & PERFORMANCE CENTER LLC
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Dates
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Enumeration Date | 12/07/2024
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 201 RIVER ST STE 203
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City | ELK RAPIDS
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State | MI
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Zip | 49629-9605
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Country | US
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Telephone | 810-931-9478
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 313
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City | ELK RAPIDS
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State | MI
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Zip | 49629-0313
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Country | US
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Telephone | 810-931-9478
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Fax |
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Authorized Official
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Title or Position | OWNER/ CHIROPRACTOR
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Name | ALEX CESAL
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Credential | DC
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Telephone | 810-931-9478
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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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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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