| NPI | 1033546049 |
|---|---|
| Doing Business As | SACRED WATERS WELLNESS |
| Entity Type | Organization |
| Authorized Contact | KELLY JEFFERSON Managing Directo 770-460-9122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |