MOONBEAM MASSAGE LLC NPI 1154659340

NPI Information

NPI: 1154659340
Provider Name: MOONBEAM MASSAGE LLC
Classification: Massage Therapist - 225700000X
Entity Type: Organization
Address:
5885 S MAIN ST
SUITE 2
CLARKSTON, MI
ZIP 48346
Phone: (248) 933-6534
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MOONBEAM MASSAGE LLC is a massage therapist in Clarkston, MI. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. MOONBEAM MASSAGE LLC NPI is 1154659340. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5885 S MAIN ST
SUITE 2
CLARKSTON, MI
ZIP 48346-981
Phone: (248) 933-6534

The provider's authorized official is Judy Ann Schornak .
The authorized official title is Owner and has the following contact phone number (248) 933-6534.

The enumeration date for this NPI number is 11/26/2009 and was last updated on 11/26/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1106317	OTHER		AMERICAN SPECIALTY HEALTH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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