Organization
THE WILD DAUGHTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MADISON K BARENSE LMT (OWNER)
(616) 710-1851
Entity
Organization
Contact information
Practice address
509 MICHIGAN AVE, HOLLAND, MI 49423-4750
(616) 710-1851
Mailing address
1041 E 16TH ST APT 207, HOLLAND, MI 49423-9173
(616) 312-3609
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
04/19/2021
Last updated
04/19/2021
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