Provider Demographics
NPI:1932882982
Name:ESSENTIAL AROMA MMT, LLC
Entity Type:Organization
Organization Name:ESSENTIAL AROMA MMT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIERDRA
Authorized Official - Middle Name:DEE
Authorized Official - Last Name:FLOURRY-REMBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMMT, ADS
Authorized Official - Phone:616-706-7751
Mailing Address - Street 1:5165 KALAMAZOO AVE SE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4825
Mailing Address - Country:US
Mailing Address - Phone:616-717-2951
Mailing Address - Fax:
Practice Address - Street 1:5165 KALAMAZOO AVE SE UNIT 2
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4825
Practice Address - Country:US
Practice Address - Phone:616-717-2951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1659059913OtherPROVIDER NPI