Provider Demographics
NPI:1184333114
Name:NEURON FIRE YOGA LLC
Entity type:Organization
Organization Name:NEURON FIRE YOGA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAKOSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:906-286-0483
Mailing Address - Street 1:30445 NORTHWESTERN HWY STE 230
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30445 NORTHWESTERN HWY STE 230
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3109
Practice Address - Country:US
Practice Address - Phone:906-286-0483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-17
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty