Organization
WAVE LIFE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGARET ANNE MELTON (CHIEF EXECUTIVE ASSISTANT)
(580) 291-6961
Entity
Organization
Contact information
Practice address
158 GOYA RD, PORTOLA VALLEY, CA 94028-7307
(917) 601-6840
Mailing address
700 EL CAMINO REAL STE 120, MENLO PARK, CA 94025-4884
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
—
—
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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