Individual
MR. DAVID GERARD DEOLDEN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
7868 PECK ROAD, KIRKVILLE, NY 13082
(315) 400-7909
Mailing address
7868 PECK ROAD, KIRKVILLE, NY 13082
(315) 400-7909
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026355
NY
Other
Enumeration date
08/09/2023
Last updated
08/09/2023
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