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NPI 1366748600

NPI 1366748600 : MEGHAN T H CALI LMT : JORDAN, NY

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General NPI Number Information
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    NPI Number           |    1366748600
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    Entity Type          |    Individual 
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    Provider Name        |    MEGHAN T H CALI LMT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/03/2011
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    Last Update Date     |    02/03/2011
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Provider Practice Location Address
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    Address Line         |    1 NORTH MAIN ST. 
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    City                 |    JORDAN
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    State                |    NY
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    Zip                  |    13080
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    Country              |    US
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    Telephone            |    315-689-1393
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    Fax                  |    315-689-1393
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Provider Business Mailing Address
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    Address Line         |    PO BOX 312 1-3 NORTH MAIN ST.
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    City                 |    JORDAN
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    State                |    NY
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    Zip                  |    13080-0312
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    Country              |    US
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    Telephone            |    315-689-1393
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    Fax                  |    315-689-1393
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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       |    012661
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    License Number State |    NY
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