Individual
CAMERON WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34 HEMPSTEAD TPKE, SOUTH FARMINGDALE, NY 11735-2034
(516) 755-5855
Mailing address
24 PANDORA DR, BRENTWOOD, NY 11717-1912
(516) 360-8049
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
01/07/2020
Last updated
01/07/2020
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