Provider Demographics
NPI:1669839635
Name:L A THERAPIES
Entity Type:Organization
Organization Name:L A THERAPIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSE MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:734-489-4677
Mailing Address - Street 1:2911 GRANT DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1259
Mailing Address - Country:US
Mailing Address - Phone:734-489-4677
Mailing Address - Fax:
Practice Address - Street 1:5417 WHITTAKER RD
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-9751
Practice Address - Country:US
Practice Address - Phone:734-489-4677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-21
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501006727225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty