Individual
TINA DESTRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
135 THORNDALE AVE, WEST SENECA, NY 14224-1877
(716) 480-0242
Mailing address
135 THORNDALE AVE, WEST SENECA, NY 14224-1877
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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