Healthcare Provider Details

I. General information

NPI: 1356538359
Provider Name (Legal Business Name): DEBRA MARIE ZOTTIN LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2007
Last Update Date: 10/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

969 MAPLE RD
WILLIAMSVILLE NY
14221-3328
US

IV. Provider business mailing address

969 MAPLE RD
WILLIAMSVILLE NY
14221-3328
US

V. Phone/Fax

Practice location:
  • Phone: 716-863-5323
  • Fax:
Mailing address:
  • Phone: 716-863-5323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number008488-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: