Port Jefferson Therapeutic Massage P.c.

NPI #1861156036 in Port Jeff Sta, New York

Provider Information

NPI Number: 1861156036
Entity Type: Organization
Organization Name: Port Jefferson Therapeutic Massage P.c.
Primary Specialty: Massage Therapist
Enumeration Date: Oct 25, 2021
Last Updated: Oct 25, 2021

Practice Location

Address: 716 ROUTE 112
City: Port Jeff Sta
State: New York
ZIP Code: 11776-1025
Phone: (631) 331-7631

Authorized Official

Name: JENIFER KIRBY, LMT, PTA
Title: OWNER
Phone: (631) 331-7631

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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