Organization
SERENITY SOURCE MASSAGE CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE RANDAZZO LMT (PRESIDENT)
(631) 419-6300
Entity
Organization
Contact information
Practice address
18 WEEKS ST, BLUE POINT, NY 11715-1513
(631) 419-6300
Mailing address
18 WEEKS ST, BLUE POINT, NY 11715-1513
(631) 419-6300
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
01/06/2021
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