Individual
STACEY M HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5 NASSAU BLVD, GARDEN CITY, NY 11530-5340
(516) 505-1008
Mailing address
PO BOX 5092, MONTAUK, NY 11954-0906
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
011836-1
NY
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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