MRS. Maria Jean Mirissis, MASSAGE THERAPIST

NPI #1003391665 in Northport, New York

Provider Information

NPI Number: 1003391665
Entity Type: Individual
Name: MRS. Maria Jean Mirissis, MASSAGE THERAPIST
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: MASSAGE THERAPIST
Enumeration Date: Sep 30, 2018
Last Updated: Sep 30, 2018

Practice Location

Address: 10 FORT SALONGA RD STE 2A
City: Northport
State: New York
ZIP Code: 11768-1465
Phone: (631) 343-9194

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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