Revitalize Day Spa

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

2706122912 Issued in MI

Legal business name

REVITALIZE DAY SPA

Practice address

751 Chestnut St
203
Birmingham, MI 48009-6461

Phone

(248) 530-4772

NPI assigned

Feb 17, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Chris John Ygay

Title

Owner

Phone

(248) 530-4772

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1093088288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 CHESTNUT ST",
            "address_2": "SUITE 203 AND 205",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096461",
            "telephone_number": "248-530-4001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 CHESTNUT ST",
            "address_2": "203",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480096461",
            "telephone_number": "248-530-4772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVITALIZE DAY SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "YGAY",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-530-4772",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "2706122912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Danielle Reich, MT-BC
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• Right Bite LLC
• Mark L Riley, DPM

• Massage Therapist in Birmingham, MI
• Providers in Birmingham, MI by specialty
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.