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General NPI Number Information
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NPI Number | 1548528631
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Entity Type | Individual
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Provider Name | NICOLE MARIE MCKEONE LMT.
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Gender | Female
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 5854 A SNYDER DR.
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City | LOCKPORT
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State | NY
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Zip | 14094
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Country | US
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Telephone | 716-392-1550
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Fax | 716-434-3868
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Provider Business Mailing Address
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Address Line | 570 NIAGRA FALLS BLVD
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City | TONAWANDA
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State | NY
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Zip | 14223
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Country | US
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Telephone | 716-392-1550
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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 | 27019922
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License Number State | NY
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