Individual
KOSTADINA COOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
109 S WARREN ST STE 301, SYRACUSE, NY 13202-1798
(315) 636-3835
Mailing address
315 PLYMOUTH DR, SYRACUSE, NY 13206-2345
(315) 256-2216
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
032664
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032664
NYS MASSAGE THERAPY LICENSE
NY
Enumeration date
03/24/2022
Last updated
03/24/2022
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