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General NPI Number Information
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NPI Number | 1194172536
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Entity Type | Organization
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Legal Business Name | SERENITY FOR WELLNESS
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Dates
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Enumeration Date | 05/16/2016
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Last Update Date | 05/16/2016
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Provider Practice Location Address
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Address Line | 3220 BUTNER RD SW SUITE 130
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City | ATLANTA
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State | GA
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Zip | 30331-8200
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Country | US
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Telephone | 678-228-7639
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Fax | 855-680-2626
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Provider Business Mailing Address
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Address Line | 3220 BUTNER RD SW SUITE 130
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City | ATLANTA
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State | GA
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Zip | 30331-8200
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Country | US
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Telephone | 678-228-7639
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Fax | 855-680-2626
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Authorized Official
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Title or Position | OWNER
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Name | TIFFANY TERRY
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Credential |
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Telephone | 678-228-7639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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