Healthcare Provider Details

I. General information

NPI: 1831150978
Provider Name (Legal Business Name): CATHERINE MICHELLE RHOADS L.M.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 LAKE AVE
HILTON NY
14468-1198
US

IV. Provider business mailing address

18 HILLTOP DR
LE ROY NY
14482-1420
US

V. Phone/Fax

Practice location:
  • Phone: 585-392-4100
  • Fax:
Mailing address:
  • Phone: 585-749-6915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number013232-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: