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General NPI Number Information
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NPI Number | 1417180407
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Entity Type | Individual
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Provider Name | JAMAL O'NEILL LMT
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Gender | Female
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Dates
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Enumeration Date | 08/25/2009
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Last Update Date | 08/25/2009
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Provider Practice Location Address
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Address Line | 501 W KLEIN RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-1603
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Country | US
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Telephone | 716-689-8915
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Fax |
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Provider Business Mailing Address
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Address Line | 634 AMHERST ST
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City | BUFFALO
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State | NY
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Zip | 14207-2926
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Country | US
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Telephone | 716-574-3053
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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 | 020483
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License Number State | NY
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