Individual
MIRANDA WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3540 WHEELER RD STE 314, AUGUSTA, GA 30909-1885
(478) 206-7146
Mailing address
PO BOX 5326, AUGUSTA, GA 30916-5326
(478) 206-7146
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT010515
GA
225700000X
Massage Therapist
—
GA
Other
Enumeration date
02/02/2024
Last updated
03/21/2025
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