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Individual

MR. LAWRENCE FRANK ROCKWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
2306 WEST FULTON ROAD, WARNERVILLE, NY 12187-3415
(518) 657-9923
(518) 234-1476
Mailing address
PO BOX 86, WARNERVILLE, NY 12187-0086
(518) 657-9923
(518) 234-1476

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
020057-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020057-1
REGISTRATION CERTIFICATE
NY
01
516334-06
NATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE & BODYWORK
NY
Enumeration date
11/01/2018
Last updated
11/01/2018
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