Individual
BONNIE K MADISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4682 TELEGRAPH RD, BLISS, NY 14024-9626
(585) 493-5271
Mailing address
4682 TELEGRAPH RD, BLISS, NY 14024-9626
(585) 493-5271
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009958-1
NY
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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