MEDICARE: DEEP TISSUE REHABILITATION THERAPY

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	:	1669324141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEEP TISSUE REHABILITATION THERAPY

Provider Business Mailing Address
First Line	:	32780 GRAND RIVER AVE STE 212A
Second Line	:
City	:	FARMINGTON
State	:	MI
Zip	:	48336-3138
Country	:	US
Telephone Number	:	248-275-4001
Fax Number	:

Provider Business Practice Location Address
First Line	:	32780 GRAND RIVER AVE STE 212A
Second Line	:
City	:	FARMINGTON
State	:	MI
Zip	:	48336-3138
Country	:	US
Telephone Number	:	248-275-4001
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTOPHER LAUGHHUNN
Credential	:	LMT
Telephone Number	:	248-275-4001

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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Directions to “DEEP TISSUE REHABILITATION THERAPY ” Practice Location

Language	Start Address	Practice Location

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