Bridget Elizabeth Walts, LMT

Individual provider Active NPI Massage Therapist · Phoenix, NY

NPI 1811380801 · NPPES record last updated Mar 15, 2015

Key facts

NPI
1811380801
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
27 028627 (NY)
Practice address
885 County Route 57
Phoenix, NY 13135-2197
Phone
(315) 420-1634
NPI assigned
Mar 15, 2015
Sex
Female
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
27 028627NYMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 27 028627 NY Yes

Addresses

Primary practice location

885 County Route 57
Phoenix, NY 13135-2197

Mailing address

885 County Route 57
Phoenix, NY 13135-2197
Phone (315) 420-1634

Other providers in Phoenix, NY

All providers in Phoenix, NY · Massage Therapist in New York

Sources for this page

Verify at the official NPI Registry.