Individual
JEAN VANETTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
693 EAST AVE, RETREAT HOUSE MASSAGE AND WELLNESS CENTER, ROCHESTER, NY 14607-2152
(585) 271-7690
Mailing address
37 RED POST CRES, FAIRPORT, NY 14450-9317
(585) 415-7825
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
016429
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016429
LMT LICENSE #
NY
Enumeration date
03/12/2007
Last updated
07/08/2007
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