MEDICARE: MS. JENNIFER ROBIN KLOC MASSAGE THERAPIST

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
1	225700000X	Massage Therapist	031728	NY

General Provider Information

NPI Number	:	1922706308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER ROBIN KLOC MASSAGE THERAPIST

Provider Business Mailing Address
First Line	:	1909 UNION RD
Second Line	:
City	:	WEST SENECA
State	:	NY
Zip	:	14224-2013
Country	:	US
Telephone Number	:	716-675-3380
Fax Number	:	716-675-3380

Provider Business Practice Location Address
First Line	:	1909 UNION RD
Second Line	:
City	:	WEST SENECA
State	:	NY
Zip	:	14224-2013
Country	:	US
Telephone Number	:	716-675-3380
Fax Number	:	716-675-3380

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2023
Last Update Date	:	02/16/2023

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