Individual
ADAMA MAYNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
623 BROADWAY, MASSAPEQUA, NY 11758-5027
(516) 781-1078
Mailing address
623 BROADWAY, MASSAPEQUA, NY 11758-5027
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032002
NY
Other
Enumeration date
07/26/2022
Last updated
07/26/2022
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