Organization
PORT JEFFERSON THERAPEUTIC MASSAGE P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENIFER KIRBY LMT, PTA (OWNER)
(631) 331-7631
Entity
Organization
Contact information
Practice address
716 ROUTE 112, PORT JEFF STA, NY 11776-1025
(631) 331-7631
Mailing address
716 ROUTE 112, PORT JEFF STA, NY 11776-1025
(631) 331-7631
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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