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Individual

AUTUMN KOHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1 W 34TH ST RM 204, NEW YORK, NY 10001-3011
(212) 600-4808
Mailing address
245 E 25TH ST APT 4C, NEW YORK, NY 10010-3043
(646) 255-6281

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
027163-1
NY

Other

Enumeration date
06/20/2021
Last updated
06/20/2021
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