Organization
MOONBEAM MASSAGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY ANN SCHORNAK MT (OWNER)
(248) 933-6534
Entity
Organization
Contact information
Practice address
5885 S MAIN ST, SUITE 2, CLARKSTON, MI 48346-2981
(248) 933-6534
Mailing address
5885 S MAIN ST, SUITE 2, CLARKSTON, MI 48346-2981
(248) 933-6534
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106317
AMERICAN SPECIALTY HEALTH
—
Enumeration date
11/26/2009
Last updated
11/26/2009
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