Individual
CARLA ROSE VANDEUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
266 SMITH AVE, KINGSTON, NY 12401-3428
(845) 338-6045
Mailing address
266 SMITH AVE, KINGSTON, NY 12401-3428
(845) 338-6045
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
012251-1
NY
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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