Organization

Blaq Therapy

Legal Business Name

Blaq Therapy

NPI Number

1609646256

NPI Type

Organization

Enumeration Date

01/04/2024

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 714
24073 CRESCENT ST

City

Mattawan
Mattawan

State

MI
MI

Postal Code

49071-0714
49071-8457

Country

US
US

Telephone Number

N/A
(734) 802-7667

Authorized Official

Name

Anter Abdallah

Title or Position

CREDENTIALER

Telephone Number

(734) 802-7667

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/04/2024

Provider Address