Individual
JACQUELYNN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
32 WERGER RD, WEST SAND LAKE, NY 12196-2013
(518) 424-9580
Mailing address
32 WERGER RD, WEST SAND LAKE, NY 12196-2013
(518) 424-9580
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
011719-1
NY
Other
Enumeration date
11/08/2018
Last updated
11/08/2018
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