Individual
CAROLINE MARIE CARBALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4437 MAIN ST, GASPORT, NY 14067-9201
(716) 772-2200
Mailing address
PO BOX 281, GASPORT, NY 14067-0281
(716) 772-2200
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
026968-1
NY
Other
Enumeration date
04/30/2013
Last updated
04/30/2013
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