Individual
JESSICA JEAN KIDDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7383 UTICA BLVD, LOWVILLE, NY 13367-9503
(315) 376-2256
Mailing address
7383 UTICA BLVD, LOWVILLE, NY 13367-9503
(315) 376-2256
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
021752-1
NY
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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