Individual
BETHANY GRATIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 E GENESEE ST, BALDWINSVILLE, NY 13027-2565
(315) 372-2803
Mailing address
72 ELM ST, CAMILLUS, NY 13031-1025
(315) 372-2803
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026548
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
026548
LICENSE
NY
Enumeration date
03/27/2015
Last updated
07/03/2023
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