Most Relevant Information
Provider Data
| NPI Number: | 1003003377 |
| Provider Name: | KATHLEEN PRENDERGAST OTR, LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 014927-1 |
Most Important Dates
| Enumeration Date: | 10/01/2007 |
| Last Updated: | 10/01/2007 |
Provider Practice Location
210 E MAIN ST
SPRINGVILLE
NY
141411442
Practice Location Phone/Fax
| Phone: | 7165607315 |
| Fax: |
Provider Mailing Location
9568 DARIEN RD
WEST FALLS
NY
141709611
Provider Mailing Phone/Fax
| Phone: | 7165607315 |
| Fax: |