Individual
MARTINA MARY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 E 30TH ST APT 46, NEW YORK, NY 10016-8210
(917) 544-0204
(917) 544-0204
Mailing address
201 E 30TH ST APT 46, NEW YORK, NY 10016-8210
(917) 544-0204
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
012153-1
NY
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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