Most Relevant Information
Provider Data
| NPI Number: | 1003307711 |
| Provider Name: | PAMELA LEE WALTERS LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 006973-1 |
Most Important Dates
| Enumeration Date: | 05/29/2018 |
| Last Updated: | 05/29/2018 |
Provider Practice Location
209 BROADWAY
AMITYVILLE
NY
117012705
Practice Location Phone/Fax
| Phone: | 6316910200 |
| Fax: |
Provider Mailing Location
209 BROADWAY
AMITYVILLE
NY
117012705
Provider Mailing Phone/Fax
| Phone: | 6316910200 |
| Fax: |