Individual
COLLEEN MCMAHON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2848 MIDDLE COUNTRY RD, LAKE GROVE, NY 11755-2104
(631) 648-8835
(631) 285-2124
Mailing address
18 HAMILTON PL, LAKE GROVE, NY 11755-1915
(516) 454-6387
(516) 454-6303
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
004396
NY
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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