Most Relevant Information
Provider Data
| NPI Number: | 1003213232 |
| Provider Name: | MARISA CHADBOURNE LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 021161 |
Most Important Dates
| Enumeration Date: | 12/03/2014 |
| Last Updated: | 06/29/2023 |
Provider Practice Location
124 MAIN STREET
SAYVILLE
NY
117822952
Practice Location Phone/Fax
| Phone: | 6314036013 |
| Fax: |
Provider Mailing Location
PO BOX 53
SAYVILLE
NY
117820053
Provider Mailing Phone/Fax
| Phone: | 6314036013 |
| Fax: |