Individual
JENNIFER MARIE MERRILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
573 MIDDLE RD, BAYPORT, NY 11705-1916
(631) 868-3232
Mailing address
573 MIDDLE ROAD, BAYPORT, NY 11705-1806
(631) 868-3232
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
017324-1
NY
Other
Enumeration date
06/14/2017
Last updated
06/21/2017
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