Organization
FUNCTIONAL MASSAGE THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY COLE (DIRECTOR/LICENSED MASSAGE THERAPIST)
(631) 730-8300
Entity
Organization
Contact information
Practice address
755 WAVERLY AVE, SUITE #206, HOLTSVILLE, NY 11742-1190
(631) 730-8300
Mailing address
755 WAVERLY AVE, SUITE #206, HOLTSVILLE, NY 11742-1190
(631) 730-8300
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018019
NY
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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