Individual
MS. JULIA CORBALLY-CARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
22 ANDREW AVE, ROUND LAKE, NY 12151-7713
(518) 937-3264
Mailing address
P.O. BOX 554, ROUND LAKE, NY 12151
(518) 937-3264
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27028659
NY
Other
Enumeration date
10/17/2016
Last updated
10/17/2016
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