Organization
EXODUS HAIR & NAIL STUDIO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KANDY WAGNER M.T. (OWNER)
(586) 242-5729
Entity
Organization
Contact information
Practice address
21526 HARPER AVE, SAINT CLAIR SHORES, MI 48080-2210
(586) 242-5729
Mailing address
21526 HARPER AVE, ST. CLAIR SHORES, MI 48080
(586) 242-5729
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
332924-00
MI
Other
Enumeration date
03/20/2017
Last updated
03/20/2017
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