Individual
MS. KRISTY GENUNG DIBELKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4079 LAKE RD N, BROCKPORT, NY 14420-1517
(585) 697-4489
Mailing address
4079 LAKE RD N, BROCKPORT, NY 14420-1517
(585) 697-4489
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
017374-1
NY
Other
Enumeration date
03/25/2008
Last updated
03/25/2008
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