Individual
WENDIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5993 SANDBANK RD, JORDAN, NY 13080-8601
(315) 224-0024
Mailing address
5993 SANDBANK RD, JORDAN, NY 13080-8601
(315) 224-0024
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032514
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032514
MASSAGE THERAPY LICENSE
NY
Enumeration date
05/09/2021
Last updated
05/09/2021
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