Individual
WAYNE ARCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2065 E 57TH ST, BROOKLYN, NY 11234-4701
(718) 313-8206
Mailing address
2065 E 57TH ST, BROOKLYN, NY 11234-4701
(718) 313-8206
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030505-1
NY
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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