Individual provider · Type 1 NPI

Marie Fanham, LMT

Massage Therapist · Brockport, NY

NPI number 1295189017 Active

Practice location

29 Clinton St
Brockport, NY 14420-1803

Call (585) 637-3126 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X029413-1 (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 1295189017

Marie Fanham, LMT's National Provider Identifier is 1295189017, issued on Apr 18, 2016. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Brockport, NY. The record was last updated on Apr 18, 2016.