Provider Demographics
NPI:1083594881
Name:WISH U WELLNESS
Entity type:Organization
Organization Name:WISH U WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:B
Authorized Official - Last Name:MCKENZIE
Authorized Official - Suffix:
Authorized Official - Credentials:NATUROPATH
Authorized Official - Phone:404-683-0095
Mailing Address - Street 1:54366 SHOAL CRK
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-4773
Mailing Address - Country:US
Mailing Address - Phone:404-683-0095
Mailing Address - Fax:404-683-0095
Practice Address - Street 1:54366 SHOAL CRK
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-4773
Practice Address - Country:US
Practice Address - Phone:404-683-0095
Practice Address - Fax:404-683-0095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty