Individual
KERRY SPEIDELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT 023361-1
Contact information
Practice address
26 SHENANDOAH BLVD, NESCONSET, NY 11767-2319
(607) 778-0887
Mailing address
26 SHENANDOAH BLVD, NESCONSET, NY 11767-2319
(607) 778-0887
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023361-1
NY
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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