Individual
SHANTHY JAYAKUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
466 NIAGARA FALLS BLVD, BUFFALO, NY 14223-2623
(716) 636-1679
Mailing address
159 BROCKMOORE DR, EAST AMHERST, NY 14051-2138
(716) 636-1679
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
024937
NY
Other
Enumeration date
04/01/2011
Last updated
04/01/2011
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