Individual
JULIE REA MCTAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LIC.MTH.
Contact information
Practice address
159 POTTER AVE, STATEN ISLAND, NY 10314-3025
(718) 720-1204
Mailing address
159 POTTER AVE, STATEN ISLAND, NY 10314-3025
(718) 720-1204
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
003222-1
NY
Other
Enumeration date
01/02/2017
Last updated
01/02/2017
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