Provider Demographics
NPI:1386885895
Name:ESSENTIAL MASSAGE & WELLNESS CENTER, LLC
Entity type:Organization
Organization Name:ESSENTIAL MASSAGE & WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-714-9901
Mailing Address - Street 1:1641 S MILFORD RD STE B
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4889
Mailing Address - Country:US
Mailing Address - Phone:248-714-9901
Mailing Address - Fax:248-714-9904
Practice Address - Street 1:1641 S MILFORD RD STE B
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357-4889
Practice Address - Country:US
Practice Address - Phone:248-714-9901
Practice Address - Fax:248-714-9904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty