Medical Massage Clinic of Mi., LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

MEDICAL MASSAGE CLINIC OF MI., LLC

Practice address

17151 Wyoming St
Detroit, MI 48221-2451

Phone

(313) 566-4828

Fax

(313) 566-4828

NPI assigned

Jul 22, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Keli Coleman

Title

Administrator Executive

Phone

(313) 566-4828

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374451200000",
    "number": "1093157802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17151 WYOMING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212451",
            "telephone_number": "313-566-4828",
            "fax_number": "313-566-4828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17151 WYOMING ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212451",
            "telephone_number": "313-566-4828",
            "fax_number": "313-566-4828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL MASSAGE CLINIC OF MI., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-22",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "KELI",
        "authorized_official_title_or_position": "ADMINISTRATOR EXECUTIVE",
        "authorized_official_telephone_number": "313-566-4828",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Detroit, MI
• Providers in Detroit, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2013; 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.