Individual
MRS. TONYA RAE COLBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
40 NORTH AVE, WEBSTER, NY 14580-3056
(585) 330-2832
Mailing address
40 NORTH AVE, WEBSTER, NY 14580-3056
(585) 330-2832
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
017178-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
156650GG
PREFERRED CARE PROVIDER
NY
Enumeration date
03/05/2007
Last updated
07/08/2007
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