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Organization

BELLIS

Active
Other names
Bellis Therapeutic Spa
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BRANDI ELLIS MT., ESTHETICIAN (OWNER)
(248) 442-0034
Entity
Organization

Contact information

Practice address
33037 GRAND RIVER AVE, FARMINGTON, MI 48336-3119
(248) 442-0034
Mailing address
33037 GRAND RIVER AVE, FARMINGTON, MI 48336-3119
(248) 442-0034

Taxonomy

Speciality
Code
Description
License number
State
305S00000X
Point of Service
2705003188
MI
305S00000X
Point of Service
Primary
7501005119
MI

Other

Enumeration date
09/20/2015
Last updated
09/20/2015
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