Serenity Source Massage Corp

NPI #1861038291 in Blue Point, New York

Provider Information

NPI Number: 1861038291
Entity Type: Organization
Organization Name: Serenity Source Massage Corp
Primary Specialty: Massage Therapist
Enumeration Date: Nov 20, 2019
Last Updated: Jan 6, 2021

Practice Location

Address: 18 WEEKS ST
City: Blue Point
State: New York
ZIP Code: 11715-1513
Phone: (631) 419-6300

Authorized Official

Name: DIANE RANDAZZO, LMT
Title: PRESIDENT
Phone: (631) 419-6300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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