Individual
MARIA ROSE ANN DEMITCHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3444 WILLIAMS RD, MARCELLUS, NY 13108-9627
(315) 243-1695
Mailing address
3444 WILLIAMS RD, MARCELLUS, NY 13108-9627
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
015305-2
NY
Other
Enumeration date
02/19/2018
Last updated
03/17/2018
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