Provider Demographics
NPI:1306169743
Name:HOLISTIC HEALING CENTERS OF MICHIGAN INC.
Entity type:Organization
Organization Name:HOLISTIC HEALING CENTERS OF MICHIGAN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AL
Authorized Official - Middle Name:J
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PTA, MPC, IMT, C
Authorized Official - Phone:586-755-4711
Mailing Address - Street 1:4271 STODDARD RD
Mailing Address - Street 2:
Mailing Address - City:W BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-3259
Mailing Address - Country:US
Mailing Address - Phone:248-865-7686
Mailing Address - Fax:248-865-7686
Practice Address - Street 1:4271 STODDARD RD
Practice Address - Street 2:
Practice Address - City:W BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-3259
Practice Address - Country:US
Practice Address - Phone:248-865-7686
Practice Address - Fax:248-865-7686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55020002472251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty