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1992334692
SAMUEL KENT AXTEN
ROUND LAKE, NY
NPI
1992334692
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: NY 029143)
Enumeration Date
2020-04-04
Last Update Date
2020-04-04
Business Address
SAMUEL KENT AXTEN LMT
2101 ROUTE 9
ROUND LAKE, NY 12151-1711
Phone number: 518-669-5462
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Mailing Address
SAMUEL KENT AXTEN LMT
10 PARTRIDGE GLN
REXFORD, NY 12148-1344
Phone number: 518-669-5462
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