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General NPI Number Information
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NPI Number | 1336581495
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Entity Type | Individual
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Provider Name | JESUS E SKRLIN LMT
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Gender | Male
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Dates
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Enumeration Date | 07/18/2013
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 820 MAIN ST.
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City | NIAGARA FALLS
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State | NY
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Zip | 14301
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Country | US
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Telephone | 716-283-7979
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 713 FALLS STATION
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City | NIAGARA FALLS
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State | NY
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Zip | 14303
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Country | US
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Telephone | 716-579-4688
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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 | 024580
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License Number State | NY
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