Individual
MR. NICHOLAS DANIEL PAVOLDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SIP, LMT
Contact information
Practice address
578 NEW LOUDON RD, LATHAM, NY 12110-4038
(518) 389-2200
Mailing address
578 NEW LOUDON RD, LATHAM, NY 12110-4038
(518) 389-2200
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009737
NY
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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