Individual
MS. DIANE ELAINE MCMILLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
913 N BROADWAY, MASSAPEQUA, NY 11758-2364
(631) 355-7300
Mailing address
146 RAILROAD AVE, BETHPAGE, NY 11714-2438
(516) 808-4914
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/07/2018
Last updated
07/07/2018
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