Individual
CONAN MERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
1050 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776-1214
(631) 681-5875
Mailing address
144 GNARLED HOLLOW RD, EAST SETAUKET, NY 11733-1976
(631) 681-5875
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
028169
NY
Other
Enumeration date
06/25/2015
Last updated
10/07/2023
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