Individual
MR. ZACKARY DAVID MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
821 CLIFF ST, ITHACA, NY 14850-2097
(607) 256-9355
Mailing address
482 SHELDON RD APT 8, FREEVILLE, NY 13068-9773
(607) 242-2404
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030830
NY
Other
Enumeration date
08/04/2018
Last updated
08/04/2018
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