Individual
MICHELLE GOMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
500 PORTION RD, RONKONKOMA, NY 11779-4587
(631) 588-2100
Mailing address
500 PORTION RD STE 17, RONKONKOMA, NY 11779-4587
(347) 675-5341
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
025405-1
NY
Other
Enumeration date
06/04/2019
Last updated
09/23/2021
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