Miracle Salon & Spa Dba Natural Wellness

Primary specialty

MechanotherapistTaxonomy code 172M00000X

License

10293 Issued in OH

Legal business name

MIRACLE SALON & SPA DBA NATURAL WELLNESS

Practice address

6632 Summerfield Rd
Temperance, MI 48182-1339

Phone

(734) 850-9355

Fax

(734) 850-9356

NPI assigned

May 4, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Michael Hollerbach, LMT

Title

Clinical Director

Phone

(734) 850-9355

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376755918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6632 SUMMERFIELD RD",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "481821339",
            "telephone_number": "734-850-9355",
            "fax_number": "734-850-9356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6632 SUMMERFIELD RD",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "481821339",
            "telephone_number": "734-850-9355",
            "fax_number": "734-850-9356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRACLE SALON & SPA DBA NATURAL WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLLERBACH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "734-850-9355",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "172M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Mechanotherapist",
            "state": "OH",
            "license": "10293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mechanotherapist in Temperance, MI
• Providers in Temperance, MI by specialty
• Mechanotherapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.