Tracie L Baxter, L.M.T

Individual provider Active NPI Massage Therapist · Whitney Point, NY

NPI 1962705855 · NPPES record last updated Dec 15, 2010

Key facts

NPI
1962705855
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
014189-1 (NY)
Practice address
260 Kales Hill Rd
Whitney Point, NY 13862-1622
Phone
(607) 692-3961
Fax
(607) 692-2514
NPI assigned
Dec 15, 2010
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
014189-1NYMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 014189-1 NY Yes

Addresses

Primary practice location

260 Kales Hill Rd
Whitney Point, NY 13862-1622

Mailing address

260 Kales Hill Rd
Whitney Point, NY 13862-1622
Phone (607) 743-4243

Other providers in Whitney Point, NY

All providers in Whitney Point, NY · Massage Therapist in New York

Sources for this page

Verify at the official NPI Registry.