Organization
EAST END SPORTS MASSAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE KENNELLY LMT (OWNER)
(718) 683-1905
Entity
Organization
Contact information
Practice address
222 MANOR PL STE 7, GREENPORT, NY 11944-1261
(631) 268-4769
Mailing address
2595 VILLAGE LN, ORIENT, NY 11957-1469
(718) 683-1905
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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