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Individual

MS. LISA ERIKA ROSZYK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
C.M.T

Contact information

Practice address
9470 MADISON AVE, BREWERTON, NY 13029-9666
(315) 715-8111
Mailing address
9470 MADISON AVE, BREWERTON, NY 13029-9666

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
75919
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
75919
AMTA
Enumeration date
10/05/2019
Last updated
10/05/2019
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