# THERAPEUTIC MASSAGE REHABILITATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790180396
- **Authorized official:** CHRISTINE KEAVENY LMT (LICENSED MASSAGE THERAPIST)
- **Authorized official phone:** (248) 320-1310

## Contact information

- **Practice address:** 800 N MILFORD RD STE 600, MILFORD, MI 48381-1599
- **Practice address phone:** (248) 320-1310
- **Mailing address:** 1759 ASHSTAN DR, WALLED LAKE, MI 48390-2612
- **Mailing address phone:** (248) 320-1310

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 7501003479 | MI | Yes |

## Other

- **Enumeration date:** 10/27/2014
- **Last updated:** 10/27/2014