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General NPI Number Information
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NPI Number | 1891495628
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Entity Type | Individual
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Provider Name | CAITLIN GREGG MLMT
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Gender | Female
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 169 OLD MILITARY RD
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City | LAKE PLACID
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State | NY
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Zip | 12946
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Country | US
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Telephone | 838-233-9740
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Fax |
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Provider Business Mailing Address
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Address Line | 9 JOSEPH ST
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City | TUPPER LAKE
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State | NY
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Zip | 12986-1810
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Country | US
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Telephone | 585-278-7264
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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 | 029067
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License Number State | NY
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