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General NPI Number Information
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NPI Number | 1669839635
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Entity Type | Organization
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Legal Business Name | L A THERAPIES
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/22/2016
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Provider Practice Location Address
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Address Line | 5417 WHITTAKER RD
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City | YPSILANTI
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State | MI
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Zip | 48197-9751
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Country | US
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Telephone | 734-489-4677
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 GRANT DR
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City | ANN ARBOR
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State | MI
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Zip | 48108-1259
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Country | US
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Telephone | 734-489-4677
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Fax |
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Authorized Official
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Title or Position | LICENSE MASSAGE THERAPIST
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Name | MS. LATOYA A HUNTER
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Credential | LMT
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Telephone | 734-489-4677
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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 | 7501006727
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License Number State | MI
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