Organization
TERRA ORGANIC SPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL M MCCLEAN LMT (OWNER)
(315) 440-7744
Entity
Organization
Contact information
Practice address
201 HIGHBRIDGE ST, FAYETTEVILLE, NY 13066-1903
(315) 637-0767
Mailing address
201 HIGHBRIDGE ST, FAYETTEVILLE, NY 13066-1903
(315) 440-7744
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
016959
NY
Other
Enumeration date
01/31/2018
Last updated
01/31/2018
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