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General NPI Number Information
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NPI Number | 1033865472
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Entity Type | Individual
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Provider Name | MICHELLENE COFFEY PARTRIDGE
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Gender | Female
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Dates
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Enumeration Date | 02/24/2022
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 8151 N MAIN ST
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City | EDEN
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State | NY
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Zip | 14057-1137
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Country | US
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Telephone | 716-361-2732
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Fax |
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Provider Business Mailing Address
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Address Line | 7611 N STATE RD
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City | EDEN
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State | NY
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Zip | 14057-9665
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Country | US
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Telephone | 716-992-4958
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 009067
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License Number State | NY
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