IndividualActive
Andre Lately
NPI 1689941783 · Massage Therapist · Redford, MI
Provider details
- NPI number
- 1689941783
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- No
Mailing address
Po Box 4388
Detroit, MI 48204-0388
Registry dates
- Enumerated
- 2011-11-18
- Last updated
- 2011-11-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.