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Individual

MR. GARY STEVENS GREGORY SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
326 CAYUGA RD, BUFFALO, NY 14225-1940
(716) 632-7373
Mailing address
162 BORDEN RD, DEPEW, NY 14043-4207
(716) 698-4120

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
025710
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
025710
LICENSE MASSAGE THERAPIST
Enumeration date
01/24/2013
Last updated
01/24/2013
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