Individual
LAURA WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
7293 BUCKLEY RD STE 102, SYRACUSE, NY 13212-2648
(315) 937-5954
Mailing address
7293 BUCKLEY RD STE 102, SYRACUSE, NY 13212-2648
(315) 937-5954
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023440
NY
225700000X
Massage Therapist
7501006233
MI
Other
Enumeration date
02/26/2015
Last updated
10/05/2023
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