Tailer Boutin

NPI #1245814524 in Ronkonkoma, New York

Provider Information

NPI Number: 1245814524
Entity Type: Individual
Name: Tailer Boutin
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Enumeration Date: May 12, 2021
Last Updated: May 12, 2021

Practice Location

Address: 700 UNION PKWY STE 1
City: Ronkonkoma
State: New York
ZIP Code: 11779-7427
Phone: (516) 330-9817

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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