Individual
JACQUELYN DOLORES GRATZON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
17 WAVERLY PL, VALHALLA, NY 10595-1705
(914) 255-8366
Mailing address
17 WAVERLY PL, VALHALLA, NY 10595-1705
(914) 255-8366
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
03168101
NY
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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