Individual
ANDREA BOLTWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, LMT
Contact information
Practice address
8 BURBANK CT, GREENLAWN, NY 11740-2106
(631) 759-0072
Mailing address
8 BURBANK CT, GREENLAWN, NY 11740-2106
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030121-1
NY
Other
Enumeration date
09/04/2019
Last updated
09/04/2019
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