Individual
MR. KENNETH RAYMOND GORZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T
Contact information
Practice address
352 LAKE STREET, SOUTH FALLSBURG, NY 12779-1093
(845) 434-5600
Mailing address
352 LAKE STREET, PO BOX 1093, SOUTH FALLSBURG, NY 12779-1093
(845) 434-5600
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
015058
NY
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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