Organization
CORPORATE MIND BODY SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORESA ROBERTSON (PRESIDENT)
(313) 806-0962
Entity
Organization
Contact information
Practice address
600 RENAISSANCE CTR # 1, DETROIT, MI 48243-1815
(313) 393-7995
(313) 393-3208
Mailing address
600 RENAISSANCE CTR # 1, DETROIT, MI 48243-1815
(313) 393-7995
(313) 393-3208
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
MI
Other
Enumeration date
07/28/2009
Last updated
07/28/2009
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