Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 025835-1 | NY |
NPI | 1003467853 |
---|---|
Provider Name | Jessica Zehr |
First Address | Lowville, NY 13367-3219 |
Second Address | Lowville, NY 13367-3219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2019 |
Last Update Date | 24/09/2019 |