Provider Demographics
NPI:1225227895
Name:TERI J MICHEL
Entity Type:Organization
Organization Name:TERI J MICHEL
Other - Org Name:PRANA MASSAGE & AYURVEDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:J
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, CAHE
Authorized Official - Phone:941-240-6134
Mailing Address - Street 1:6083 MERRILL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PORT
Mailing Address - State:FL
Mailing Address - Zip Code:34287-2049
Mailing Address - Country:US
Mailing Address - Phone:941-240-6134
Mailing Address - Fax:941-240-6134
Practice Address - Street 1:6083 MERRILL ST
Practice Address - Street 2:
Practice Address - City:NORTH PORT
Practice Address - State:FL
Practice Address - Zip Code:34287-2049
Practice Address - Country:US
Practice Address - Phone:941-240-6134
Practice Address - Fax:941-240-6134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM18627261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center