Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 008161 | NY |
NPI | 1992977433 |
---|---|
Provider Name | Ms. Nancy A Smith |
First Address | Buffalo, NY 14201-1525 |
Second Address | Buffalo, NY 14201-1525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2008 |
Last Update Date | 25/03/2008 |