Individual
MAX CUATLATL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
4023 ITHACA ST APT 5RE, ELMHURST, NY 11373-1459
(718) 350-1696
Mailing address
4023 ITHACA ST APT 5RE, ELMHURST, NY 11373-1459
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
031281
NY
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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