Individual
DEWAYNE MORTIMER DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
521 E 38TH ST, BROOKLYN, NY 11203-5611
(929) 627-5643
Mailing address
521 E 38TH ST, BROOKLYN, NY 11203-5611
(929) 627-5643
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
033882
NY
Other
Enumeration date
04/30/2025
Last updated
04/30/2025
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