Healthcare Provider Details

I. General information

NPI: 1720382955
Provider Name (Legal Business Name): SERENITY BEGINS WITHIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2011
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 CENTRAL AVE
SUMMERVILLE SC
29483-3713
US

IV. Provider business mailing address

713 CENTRAL AVE
SUMMERVILLE SC
29483-3713
US

V. Phone/Fax

Practice location:
  • Phone: 843-460-7203
  • Fax:
Mailing address:
  • Phone: 843-460-7203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License Number5592
License Number StateSC

VIII. Authorized Official

Name: JENNIFER MERCHANT
Title or Position: OWNER
Credential:
Phone: 843-460-7203