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Organization

RELAXATION STATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TEDDY B BRANDON OWNER (EXECUTIVE DIRECTOR)
(269) 668-7770
Entity
Organization

Contact information

Practice address
23701 RED ARROW HWY, MATTAWAN, MI 49071-9701
(269) 668-7770
(269) 668-7770
Mailing address
23701 RED ARROW HWY, MATTAWAN, MI 49071-9701
(269) 668-7770
(269) 668-7770

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
5201001223
MI
261QP0904X
Federal Public Health Clinic/Center
Primary
31001489A
IN

Other

Enumeration date
06/22/2010
Last updated
06/22/2010
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