Individual
KIAMBU SULE DICKERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
231 W 21ST ST # CC, NEW YORK, NY 10011-3116
(212) 213-8727
Mailing address
231 W 21ST ST # CC, NEW YORK, NY 10011-3116
(212) 213-8727
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
013118
NY
Other
Enumeration date
11/19/2019
Last updated
11/19/2019
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