Individual
KRISTEN NICHOLE CHURCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
233 PARK ST, TUPPER LAKE, NY 12986-1933
(518) 354-2868
Mailing address
26 FIRST ST, TUPPER LAKE, NY 12986-2006
(518) 354-2868
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
29971
NY
Other
Enumeration date
10/04/2025
Last updated
10/04/2025
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