Individual
FREDERICK HAZLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1213 CONKLIN RD, CONKLIN, NY 13748-1405
(607) 775-0178
Mailing address
1213 CONKLIN RD, CONKLIN, NY 13748-1405
(607) 775-0178
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
012761-1
NY
Other
Enumeration date
04/27/2015
Last updated
04/27/2015
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