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1619651387
ALEKSANDR DEGTYAREV
PORT JEFFERSON, NY
NPI
1619651387
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: NY 032816)
Enumeration Date
2023-06-13
Last Update Date
2023-06-13
Business Address
ALEKSANDR DEGTYAREV LMT
318 WYNN LN
PORT JEFFERSON, NY 11777-1670
Phone number: 917-224-0464
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Mailing Address
ALEKSANDR DEGTYAREV LMT
81 WESTCHESTER DR
ROCKY POINT, NY 11778-8875
Phone number: 917-224-0464
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