Individual
SHELLEY REELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, LMT
Contact information
Practice address
1388 RT 96 N, WATERLOO, NY 13165
(315) 539-1357
Mailing address
1388 RT 96 NORTH, WATERLOO, NY 13165
(315) 539-1357
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0154041
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0154041
LMT LICENSE
NY
Enumeration date
06/10/2010
Last updated
06/10/2010
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