Individual
MR. DUSTIN DAVID ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
360 PERINTON HILLS OFFICE PARK, FAIRPORT, NY 14450-3607
(585) 217-2257
Mailing address
5 GOVERNORS CIR, MENDON, NY 14506-9606
(585) 217-2257
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023353-1
NY
Other
Enumeration date
02/04/2010
Last updated
02/04/2010
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