MEDICARE: THERAPEUTIC HEALING

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	174400000X	Specialist

General Provider Information

NPI Number	:	1851114748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC HEALING

Provider Business Mailing Address
First Line	:	360 CANTLEY ST
Second Line	:
City	:	LEONARD
State	:	MI
Zip	:	48367-6602
Country	:	US
Telephone Number	:	248-798-9386
Fax Number	:	248-605-0300

Provider Business Practice Location Address
First Line	:	360 CANTLEY ST
Second Line	:
City	:	LEONARD
State	:	MI
Zip	:	48367-6602
Country	:	US
Telephone Number	:	248-798-9386
Fax Number	:	248-605-0300

Authorized Official
Title or Position	:	OWNER
Name	:	DUANE L TRAVIS
Credential	:
Telephone Number	:	248-798-9386

Provider Enumeration Date	:	11/07/2024
Last Update Date	:	11/07/2024

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Directions to “THERAPEUTIC HEALING ” Practice Location

Language	Start Address	Practice Location

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