Individual
MR. TERRY PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
830 E BROADWAY APT 208, LONG BEACH, NY 11561-4772
(917) 626-0105
Mailing address
830 E BROADWAY APT 208, LONG BEACH, NY 11561-4772
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
02965701
NY
Other
Enumeration date
11/06/2021
Last updated
11/06/2021
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