Doctor Name: | KENDRA WIEN |
NPI Number: | 1437560992 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.M.T. |
License Number: | MAS.8066 |
Business Practice Address: | 875 W Faris Rd Greenville, SC - 296054254 |
Business Phone Number: | 8644554231 |
Business Fax Number: | |
Mailing Address: | 109 Odessa Dr, EASLEY |
State: | SC |
Postal Code: | 296407389 |
Phone Number: | 6066695947 |
Fax Number: | |
NPI Enumeration Date: | 05/17/2014 |
NPI Last Update Date: | 04/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MAS.8066 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |