Individual
MARIE HASSELBACK-COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
989 KENMORE AVE, KENMORE, NY 14217-2924
(716) 877-2728
Mailing address
386 IDEAL ST, BUFFALO, NY 14206-1109
(716) 598-4184
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
019358-1
NY
Other
Enumeration date
10/21/2015
Last updated
10/21/2015
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