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Individual

MR. NICKOLAS CLIDAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
25 CANTERBURY RD, SUITE 200, ROCHESTER, NY 14607-3403
(585) 733-0488
Mailing address
25 CANTERBURY RD, SUITE 200, ROCHESTER, NY 14607-3403
(585) 733-0488

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
027773
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
027773
NYS DEPT OF EDUCATION, MASSAGE THERAPIST LICENSE
NY
Enumeration date
12/08/2016
Last updated
12/08/2016
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