Organization
TWO HANDS DANCING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL L WAGNER CMT CERTIFIED MASSAG (OWNER)
(707) 829-7773
Entity
Organization
Contact information
Practice address
7770 HEALDSBURG AVE, SEBASTOPOL, CA 95472
(707) 827-7773
Mailing address
3427 GRAVENSTEIN HWY SO, SEBASTOPOL, CA 95472
(907) 829-0747
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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