Individual
MRS. HOLLIE ELIZABETH VANDERHEIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
193 MAIN STREET, AFTON, NY 13730
(607) 383-0553
Mailing address
193 MAIN STREET, AFTON, NY 13730
(607) 383-0553
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026994
NY
225700000X
Massage Therapist
026994-1
NY
Other
Enumeration date
11/03/2021
Last updated
06/07/2022
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