Individual
MS. JACQUELINE BONTZOLAKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2696 SHERIDAN DR, SUITE E AND F, TONAWANDA, NY 14150-9441
(716) 874-2096
Mailing address
P.O. BOX 22, 224 ENSMINGER RD, TONAWANDA, NY 14151-0022
(716) 874-2096
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27-019938
NY
Other
Enumeration date
08/12/2010
Last updated
02/14/2012
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