Individual
JANNINE WAIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5254 MERRICK RD STE 18, MASSAPEQUA, NY 11758-6206
(754) 444-2136
Mailing address
138 FORD ST, BOONVILLE, NY 13309-1217
(754) 444-2136
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
028629-01
NY
225700000X
Massage Therapist
—
—
Other
Enumeration date
03/01/2021
Last updated
04/01/2024
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