Individual
LISA MORMILE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1305 MIDDLE COUNTRY RD, SELDEN, NY 11784-2554
(631) 707-4386
Mailing address
1305 MIDDLE COUNTRY RD, SELDEN, NY 11784-2554
(631) 707-4386
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
NY
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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