Individual
MICHELLE MARIE EMILO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2605 BREWERTON RD, MATTYDALE, NY 13211-1147
(315) 455-9355
Mailing address
2605 BREWERTON RD, MATTYDALE, NY 13211-1147
(315) 455-9355
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27 026507
NY
Other
Enumeration date
01/17/2013
Last updated
01/17/2013
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