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Individual

BRIAN VANDEMORTEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
40 NORTH AVE, WEBSTER, NY 14580-3056
(585) 329-0887
Mailing address
1072 EVERWILD VW, WEBSTER, NY 14580-8741
(585) 872-3256

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
015813
NY

Other

Enumeration date
03/23/2006
Last updated
07/08/2007
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