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Individual

MS. LARISSA ANNE SPERO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
42 E MAIN ST, SMITHTOWN, NY 11787-2804
(631) 406-6611
Mailing address
1533 11TH ST, WEST BABYLON, NY 11704-3620
(631) 805-1463

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
022325
NY

Other

Enumeration date
03/16/2010
Last updated
03/16/2010
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