Individual
MISS MICHELLE LYNN BULSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3991 NY2, TROY, NY 12180-0000
(518) 892-6741
Mailing address
31 BS LN, TROY, NY 12180-9202
(518) 892-6741
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
021313-1
NY
Other
Enumeration date
09/03/2008
Last updated
09/03/2008
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