Individual
MRS. CANDACE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
210 BRIGHAM RD, GREENFIELD CENTER, NY 12833-1849
(518) 729-7047
Mailing address
210 BRIGHAM RD, GREENFIELD CENTER, NY 12833-1849
(518) 729-7047
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018922
NY
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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