Individual
MR. RADAGAST WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
349 COUNTY ROUTE 25, HAINES FALLS, NY 12436
(518) 589-0400
Mailing address
PO BOX 140, HAINES FALLS, NY 12436-0140
(518) 589-0400
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
022746-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022746-1
EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS
NY
Enumeration date
06/24/2009
Last updated
06/24/2009
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