Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 018934 | NY |
NPI | 1013377738 |
---|---|
Provider Name | Lindsey Bentley |
First Address | Hilton, NY 14468-1211 |
Second Address | Hilton, NY 14468-1211 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2016 |
Last Update Date | 24/02/2016 |