My Medical Massage
LBN: I-Revive Pllc
My Medical Massage is an health care organization with primary practice located at 525 Elliott Ave , Grand Haven MI 49417-1038. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine, Agencies / Home Health. Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine is the primary health care specialty.
I-Revive Pllc can be contacted via phone (616) 566-1603, or through Converse, Amanda M via phone (616) 377-8893.
Contact Information
Primary practice address
525 Elliott Ave
Grand Haven MI 49417-1038
Phone: (616) 566-1603
Fax: (616) 607-8588
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Preventive Medicine/Occupational Environmental Medicine | 2083P0500X | ||
| Agencies / Home Health | 251E00000X |
Profile Details
| NPI number | 1508473000 |
|---|---|
| LBN Legal business name | I-Revive Pllc |
| DBA Doing business as | My Medical Massage |
| Authorized official | Converse, Amanda M LMT, CIMT, CPMT |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 28th, 2020 |
| Last updated | Nov 5th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508473000 | NPPES |
| Michigan | Other | 14997664 | CAQH |
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