Most Relevant Information
Provider Data
| NPI Number: | 1003316795 |
| Provider Name: | MARIA ROSE ANN DEMITCHELL LMT |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: | 015305-2 |
Most Important Dates
| Enumeration Date: | 02/19/2018 |
| Last Updated: | 03/17/2018 |
Provider Practice Location
3444 WILLIAMS RD
MARCELLUS
NY
131089627
Practice Location Phone/Fax
| Phone: | 3152431695 |
| Fax: |
Provider Mailing Location
3444 WILLIAMS RD
MARCELLUS
NY
131089627
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |