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Organization

GREEN PASTURES STILL WATERS MASSAGE THERAPY & SPA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LAURA LOUISE ZIMBERG LMT (OWNER/LMT)
(716) 435-0020
Entity
Organization

Contact information

Practice address
142 LORELEE DR, TONAWANDA, NY 14150-4325
(716) 435-0020
Mailing address
142 LORELEE DR, TONAWANDA, NY 14150-4325
(716) 435-0020

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018786
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
018786
NYS LMT LICENSE
NY
01
1225201437
NPI - INDIVIDUAL
NY
Enumeration date
12/31/2014
Last updated
12/31/2014
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