Individual
JOHN DAVID LANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
43 NORTHWOOD BLVD, CENTRAL ISLIP, NY 11722-4695
(314) 070-5516
Mailing address
PO BOX 1474, CENTRAL ISLIP, NY 11722-0438
(631) 407-0551
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
09/04/2021
Last updated
09/04/2021
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