Marcos Molina Donnelly

Individual provider Active NPI Massage Therapist · Somers, CT

NPI 1124705124 · NPPES record last updated Jun 30, 2023

Key facts

NPI
1124705124
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
009684 (CT)
Practice address
151 Turnpike Rd
Somers, CT 06071-1740
Phone
(860) 406-0939
NPI assigned
Jun 30, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
009684CTMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 009684 CT Yes

Addresses

Primary practice location

151 Turnpike Rd
Somers, CT 06071-1740

Mailing address

151 Turnpike Rd
Somers, CT 06071-1740
Phone (860) 406-0939

Other providers in Somers, CT

All providers in Somers, CT · Massage Therapist in Connecticut

Sources for this page

Verify at the official NPI Registry.