Provider Demographics
NPI:1891007175
Name:GUIDED HANDS MASSAGE THERAPY
Entity Type:Organization
Organization Name:GUIDED HANDS MASSAGE THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED MASSAGE THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:BROMM
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:248-960-1402
Mailing Address - Street 1:523 N PONTIAC TRL
Mailing Address - Street 2:
Mailing Address - City:WALLED LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48390-3442
Mailing Address - Country:US
Mailing Address - Phone:248-960-1402
Mailing Address - Fax:
Practice Address - Street 1:523 N PONTIAC TRL
Practice Address - Street 2:
Practice Address - City:WALLED LAKE
Practice Address - State:MI
Practice Address - Zip Code:48390-3442
Practice Address - Country:US
Practice Address - Phone:248-960-1402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-02
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty