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General NPI Number Information
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NPI Number | 1861701690
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Entity Type | Organization
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Legal Business Name | FINGERPRINTS, LLC
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Dates
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Enumeration Date | 09/28/2010
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Last Update Date | 06/03/2013
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Provider Practice Location Address
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Address Line | 19159 MERRIMAN RD
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City | LIVONIA
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State | MI
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Zip | 48152-1754
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Country | US
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Telephone | 586-709-2347
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Fax |
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Provider Business Mailing Address
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Address Line | 20693 JOSIE CT
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City | LIVONIA
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State | MI
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Zip | 48152-4613
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Country | US
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Telephone | 586-709-2347
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Fax |
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Authorized Official
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Title or Position | MASSAGE THERAPIST
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Name | MISS WENDI MURRAY
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Credential |
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Telephone | 586-709-2347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 58189709
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License Number State | MI
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