Individual
THERESA M DEROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
704 BEACH RD, CHEEKTOWAGA, NY 14225-1756
(716) 866-4452
(716) 632-2492
Mailing address
704 BEACH RD, CHEEKTOWAGA, NY 14225-1756
(716) 866-4452
(716) 632-2492
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
018335-1
NY
Other
Enumeration date
05/25/2011
Last updated
05/25/2011
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