Individual
ALISON FASANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4205 LONG BRANCH RD., CLAY CHIROPRACTIC/ATHLONMT/STE.3, LIVERPOOL, NY 13090
(315) 956-1418
Mailing address
4805 BEAR RD APT 4K, LIVERPOOL, NY 13088-4679
(315) 956-1418
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030086
NY
Other
Enumeration date
10/13/2018
Last updated
10/13/2018
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