Provider Demographics
NPI:1992018238
Name:ALLIED MASSAGE PRACTICES INC
Entity Type:Organization
Organization Name:ALLIED MASSAGE PRACTICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ROTKO
Authorized Official - Suffix:
Authorized Official - Credentials:MA, NCMMT, NCTMB
Authorized Official - Phone:586-264-0991
Mailing Address - Street 1:4147 METROPOLITAN PKWY
Mailing Address - Street 2:STE 104
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4520
Mailing Address - Country:US
Mailing Address - Phone:586-264-0991
Mailing Address - Fax:
Practice Address - Street 1:4147 METROPOLITAN PKWY
Practice Address - Street 2:STE 104
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4520
Practice Address - Country:US
Practice Address - Phone:586-264-0991
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty