MEDICARE: GOLDEN TOUCH, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1154931228
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN TOUCH, LLC

Provider Business Mailing Address
First Line	:	4875 CHALMERS ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48215-2162
Country	:	US
Telephone Number	:	313-505-5462
Fax Number	:

Provider Business Practice Location Address
First Line	:	8325 E JEFFERSON AVE
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48214-2797
Country	:	US
Telephone Number	:	313-566-4866
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATIA FLEWELLYN
Credential	:	LMT
Telephone Number	:	313-505-5462

Provider Enumeration Date	:	08/04/2020
Last Update Date	:	08/04/2020

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Directions to “GOLDEN TOUCH, LLC ” Practice Location

Language	Start Address	Practice Location

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