Individual
MICHAEL CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
153 W 27TH ST STE 404, NEW YORK, NY 10001-6258
(917) 562-2285
Mailing address
153 W 27TH ST STE 404, NEW YORK, NY 10001-6258
(917) 562-2285
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
P11450
NY
Other
Enumeration date
07/10/2018
Last updated
07/10/2018
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