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Individual

ROBERT T DETAMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
6245 SHERIDAN DR, SUITE116, WILLIAMSVILLE, NY 14221-4834
(716) 573-6553
Mailing address
6245 SHERIDAN DR, SUITE116, WILLIAMSVILLE, NY 14221-4834
(716) 573-6553

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
020131
NY

Other

Enumeration date
03/07/2011
Last updated
03/07/2011
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