Provider Demographics
NPI:1932526506
Name:RENEW THERAPEUTIC MASSAGE LLC
Entity Type:Organization
Organization Name:RENEW THERAPEUTIC MASSAGE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CATT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-276-3424
Mailing Address - Street 1:35560 GRAND RIVER AVE
Mailing Address - Street 2:SUITE 225
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3123
Mailing Address - Country:US
Mailing Address - Phone:734-276-3424
Mailing Address - Fax:734-236-4426
Practice Address - Street 1:35560 GRAND RIVER AVE
Practice Address - Street 2:SUITE 225
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-3123
Practice Address - Country:US
Practice Address - Phone:734-276-3424
Practice Address - Fax:734-236-4426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-21
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty