Individual
COURTNEY EVANS-WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5513 MERRICK RD, MASSAPEQUA, NY 11758-6215
(516) 541-8933
Mailing address
19135 116TH AVE, SAINT ALBANS, NY 11412-3101
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
033928-01
NY
Other
Enumeration date
01/05/2026
Last updated
01/05/2026
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