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General NPI Number Information
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NPI Number | 1083594881
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Entity Type | Organization
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Legal Business Name | WISH U WELLNESS
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Dates
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Enumeration Date | 09/03/2025
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 54366 SHOAL CRK
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City | LA QUINTA
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State | CA
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Zip | 92253-4773
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Country | US
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Telephone | 404-683-0095
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Fax | 404-683-0095
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Provider Business Mailing Address
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Address Line | 54366 SHOAL CRK
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City | LA QUINTA
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State | CA
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Zip | 92253-4773
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Country | US
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Telephone | 404-683-0095
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Fax | 404-683-0095
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KERRY B MCKENZIE
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Credential | NATUROPATH
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Telephone | 404-683-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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