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NPI Code Detail

MEDICARE: MRS. MARY KUNTZ L.M.T

MEDICARE: MRS. MARY KUNTZ L.M.T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist013466-1NY

General Provider Information

NPI Number : 1619138906
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARY KUNTZ L.M.T
Provider Business Mailing Address
First Line : 58 HENRY ST
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-3232
Country : US
Telephone Number : 518-581-3180
Fax Number : 518-581-3182
Provider Business Practice Location Address
First Line : 58 HENRY ST
Second Line :
City : SARATOGA SPRINGS
State : NY
Zip : 12866-3232
Country : US
Telephone Number : 518-581-3180
Fax Number : 518-581-3182
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 06/19/2008

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