Provider Demographics
NPI:1073848362
Name:DESERT WIND THERAPEUTICS LLC
Entity Type:Organization
Organization Name:DESERT WIND THERAPEUTICS LLC
Other - Org Name:THOUSAND PETALED LOTUS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:VIESSELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:702-731-2128
Mailing Address - Street 1:2860 E FLAMINGO RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-5271
Mailing Address - Country:US
Mailing Address - Phone:702-731-2128
Mailing Address - Fax:866-378-3528
Practice Address - Street 1:2860 E FLAMINGO RD
Practice Address - Street 2:SUITE A
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-5271
Practice Address - Country:US
Practice Address - Phone:702-731-2128
Practice Address - Fax:866-378-3528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVNVMT-001225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty