Individual
JOHN JUDE REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23 JEFFERSON ST., ELLICOTTVILLE, NY 14731-0781
(716) 699-8996
Mailing address
PO BOX 781, 23 JEFFERSON ST., ELLICOTTVILLE, NY 14731-0781
(716) 699-8996
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0228311
NY
Other
Enumeration date
07/17/2009
Last updated
07/17/2009
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