Advanced Wellness Connection of Mi LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

ADVANCED WELLNESS CONNECTION OF MI LLC

Practice address

26711 Woodward Ave
Suite LL4
Huntington Woods, MI 48070-1333

Phone

(248) 542-3390

Fax

(248) 542-7659

NPI assigned

Jun 23, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Marilyn A Rotko, MA, NCMMT, MCTMBNPI 1427061050

Title

Owner/Director

Phone

(248) 542-3390

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marilyn Rotko, MA, NCMMT, NCTMB

  • Massage Therapist
  • Huntington Woods, MI
  • NPI 1427061050
  NPD (past) Authorized official

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245715200000",
    "number": "1154559607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26711 WOODWARD AVE",
            "address_2": "SUITE LL4",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701333",
            "telephone_number": "248-542-3390",
            "fax_number": "248-542-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26711 WOODWARD AVE",
            "address_2": "SUITE LL4",
            "city": "HUNTINGTON WOODS",
            "state": "MI",
            "postal_code": "480701333",
            "telephone_number": "248-542-3390",
            "fax_number": "248-542-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED WELLNESS CONNECTION OF MI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A",
        "authorized_official_last_name": "ROTKO",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "248-542-3390",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA, NCMMT, MCTMB"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Huntington Woods, MI
• Massage Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2009; 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.