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General NPI Number Information
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NPI Number | 1356628911
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Entity Type | Organization
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Legal Business Name | WELLSPRINGS MASSAGE THERAPY LLC
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 06/04/2013
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Provider Practice Location Address
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Address Line | 3183 CHILI AVE
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City | ROCHESTER
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State | NY
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Zip | 14624-5409
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Country | US
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Telephone | 585-889-7001
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Fax |
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Provider Business Mailing Address
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Address Line | 3183 CHILI AVE
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City | ROCHESTER
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State | NY
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Zip | 14624-5409
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Country | US
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Telephone | 585-889-7001
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Fax |
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Authorized Official
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Title or Position | LMT AND BUSINESS OWNER
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Name | MRS. CHRISTINE CAROL HUZYK
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Credential | LMT
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Telephone | 585-957-6776
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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 | 022947
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License Number State | NY
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