Individual
MYRTHASHA NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4155 VETERANS MEMORIAL HWY STE 5, RONKONKOMA, NY 11779-6063
(631) 412-4800
Mailing address
900 4TH ST, WEST BABYLON, NY 11704-4722
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
033071
NY
Other
Enumeration date
01/30/2023
Last updated
04/27/2023
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