Verdurous Me, Llc
Massage Therapist in Wixom, MI(View on Map)
Legal Business Name
Verdurous Me, Llc
NPI Number
1124548185
NPI Type
Organization
Enumeration Date
06/21/2017
Specialties
(Taxonomies)Code
225700000X
2255A2300X
174H00000X
175L00000X
Primary Taxonomy
Yes
No
No
No
Licenses
State
Michigan
Michigan
Michigan
License Number
7501010100
18966MIPFT
68663511
Contact
Information
Purpose
Mailing
Location
Address
25645 INGLESIDE DR
49881 GRAND RIVER AVE
City
Southfield
Wixom
State
MI
MI
Postal Code
48033-4844
48393-3309
Country
US
US
Telephone Number
N/A
(248) 229-4016
Authorized Official
Name
Leesa Hanksnecht
Title or Position
OWNER
Telephone Number
(248) 420-7439
Identifiers
Identifier
106H00000X
174H00000X
133NN1002X
175L00000X
2255A2300X
Identifier State
MI
MI
MI
MI
MI
Identifier Issuer
MARRIAGE & FAMILY SPECIALIST
HEALTH EDUCATOR
NUTRITION SPECIALIST
HOMEOPATH
SPECIALIST ATHLETIC TRAINER
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 06/22/2017