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Individual

MRS. MICHELE LEE VANDERTANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICENSED MASSAGE THE

Contact information

Practice address
738 BROWN RD, ROCHESTER, NY 14622-2316
(585) 797-7645
Mailing address
38 QUAY DR, ROCHESTER, NY 14617-1639
(585) 797-7645

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018929
NY

Other

Enumeration date
05/22/2006
Last updated
07/08/2007
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