Individual
BETH WREN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
605 PULASKI RD, EAST NORTHPORT, NY 11731-2141
(631) 239-6862
Mailing address
605 PULASKI RD, EAST NORTHPORT, NY 11731-2141
(631) 239-6862
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
01167-01
NY
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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