Individual
MR. MARK EDWARD ROOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
6605 PITTSFORD PALMYRA RD, SUITE E-9, FAIRPORT, NY 14450-3407
(585) 223-0644
Mailing address
841 GRAVEL RD, WEBSTER, NY 14580-1717
(585) 671-0449
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
007327
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1758733GG
PREFERRED CARE
NY
Enumeration date
05/04/2006
Last updated
07/08/2007
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