Individual
NATHAN FAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
74 PALOMBA DR, ENFIELD, CT 06082-3858
(860) 916-3466
Mailing address
74 PALOMBA DR, ENFIELD, CT 06082-3858
(860) 916-3466
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
4579
CT
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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