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NPI Code Detail

MEDICARE: PNEUMA BALANCE MASSAGE BODYWORK, PLLC

MEDICARE: PNEUMA BALANCE MASSAGE BODYWORK, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist025179NY

General Provider Information

NPI Number : 1871952325
Entity Type Code : Organization
Provider Name (Legal Business Name) : PNEUMA BALANCE MASSAGE BODYWORK, PLLC
Provider Business Mailing Address
First Line : 205 MARINE DR APT 2B
Second Line :
City : BUFFALO
State : NY
Zip : 14202-4215
Country : US
Telephone Number : 716-228-9843
Fax Number :
Provider Business Practice Location Address
First Line : 300 DELAWARE AVE STE 102
Second Line :
City : BUFFALO
State : NY
Zip : 14202-1807
Country : US
Telephone Number : 716-228-9843
Fax Number :
Authorized Official
Title or Position : CEO
Name : LIZZIE CORNELIA SNEED
Credential : LMT
Telephone Number : 716-228-9843
Provider Enumeration Date : 02/12/2016
Last Update Date : 02/12/2016

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Directions to “PNEUMA BALANCE MASSAGE BODYWORK, PLLC ” Practice Location

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