Individual provider · Type 1 NPI

Tailer Boutin

Massage Therapist · Ronkonkoma, NY

NPI number 1245814524 Active

Practice location

700 Union Pkwy Ste 1
Ronkonkoma, NY 11779-7427

Call (516) 330-9817 Map

Mailing address

PO Box 997
Bethpage, NY 11714-0019

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X032482 (NY)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1245814524

Tailer Boutin's National Provider Identifier is 1245814524, issued on May 12, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Ronkonkoma, NY. The record was last updated on May 12, 2021.