Individual
MELODY BLACKMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
5094 COMMERCIAL DR, YORKVILLE, NY 13495-1106
(315) 768-8521
Mailing address
105 SUNRAY TER # D, ORISKANY, NY 13424-4739
(518) 323-7460
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
028001
NY
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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