Provider Demographics
NPI:1730203779
Name:DOWNRIVER MANIPULATION
Entity type:Organization
Organization Name:DOWNRIVER MANIPULATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-783-2633
Mailing Address - Street 1:22085 BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1521
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22085 BIRCH ST
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:MI
Practice Address - Zip Code:48183-1521
Practice Address - Country:US
Practice Address - Phone:734-783-2633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty