Provider Demographics
NPI:1265550859
Name:180 RPM ENTERPRISES LLC
Entity type:Organization
Organization Name:180 RPM ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RALEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEEVER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT, MBA, NCTMB
Authorized Official - Phone:404-477-3254
Mailing Address - Street 1:PO BOX 725027
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31139-2027
Mailing Address - Country:US
Mailing Address - Phone:404-477-3254
Mailing Address - Fax:404-477-3254
Practice Address - Street 1:110 E ANDREWS DR NW
Practice Address - Street 2:SUITE 214
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-1368
Practice Address - Country:US
Practice Address - Phone:404-477-3254
Practice Address - Fax:404-477-3254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMT000055225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty