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Individual

MR. NATHAN PERRY MORAN JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
5849 TRANSIT RD, EAST AMHERST, NY 14051-1885
(716) 688-9299
Mailing address
55 BLOSSOM RD, WEST SENECA, NY 14224-2501
(716) 228-4484

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
024673
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12273891
CAQH ID
NY
Enumeration date
07/07/2011
Last updated
06/26/2013
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