Organization · NPI-2

11:11 Wellness LLC

Massage Therapist · Syracuse, NY

NPI number1063254126
StatusActive
Last updated in NPPESJun 10, 2024

Details

NPI
1063254126
Entity type
Organization (NPI-2)
Legal business name
11:11 Wellness LLC
Organization subpart
No
Enumeration date
Jun 10, 2024
Certification date
Jun 10, 2024
Last updated
Jun 10, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist––Yes

Practice location

500 W Onondaga St
Syracuse, NY 13204-3225

Phone 315-475-9164

Mailing address

500 W Onondaga St
Syracuse, NY 13204-3225

Phone 315-372-6291

Authorized official

Azariah Z Yemma
President
3153726291

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