Provider Demographics
NPI:1316774011
Name:HEAV MASSAGE STUDIOS
Entity type:Organization
Organization Name:HEAV MASSAGE STUDIOS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHIANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCLEAIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:313-685-3132
Mailing Address - Street 1:7813 PINE ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-2257
Mailing Address - Country:US
Mailing Address - Phone:313-685-3132
Mailing Address - Fax:
Practice Address - Street 1:2930 E JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207-5029
Practice Address - Country:US
Practice Address - Phone:313-685-3132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty