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1417659509
GAVIN LANCE POWELL
NEW YORK, NY
NPI
1417659509
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: GA MT014426)
Enumeration Date
2023-03-21
Last Update Date
2023-03-21
Business Address
GAVIN LANCE POWELL Massage Therapist
630 W 173RD ST
NEW YORK, NY 10032-1413
Phone number: 810-835-9314
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Mailing Address
GAVIN LANCE POWELL Massage Therapist
PO BOX 250435
NEW YORK, NY 10025-1524
Phone number: 810-835-9314
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