Individual
SCOTT JOESPH ICKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
989 KENMORE AVE, KENMORE, NY 14217-2924
(716) 335-9711
Mailing address
989 KENMORE AVE, KENMORE, NY 14217-2924
(716) 335-9711
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032805-01
NY
Other
Enumeration date
04/19/2024
Last updated
04/19/2024
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