Organization
SERENITY NOW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KANDY KAY WAGNER CMT (OWNER)
(586) 242-5729
Entity
Organization
Contact information
Practice address
38815 LAKESHORE DR, HARRISON TWP, MI 48045-2874
(586) 242-5729
Mailing address
38815 LAKESHORE DR, HARRISON TWP, MI 48045-2874
(586) 242-5729
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
332924-00
MASSAGE THERAPIST
MI
Enumeration date
05/16/2011
Last updated
05/16/2011
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