Provider Demographics
NPI:1992316871
Name:REFLEX MANUAL THERAPY LLC
Entity type:Organization
Organization Name:REFLEX MANUAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MOLTMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:586-221-0138
Mailing Address - Street 1:247 WELLINGTON CRES
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2946
Mailing Address - Country:US
Mailing Address - Phone:586-221-0138
Mailing Address - Fax:
Practice Address - Street 1:22681 MORELLI DR
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48036-1152
Practice Address - Country:US
Practice Address - Phone:586-221-0138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty