Daniel Blanco III, LMT
Massage Therapist in West Orange, NJ. Individual provider (NPI-1).
NPI number1154067494
StatusActive
Last updated in NPPESMay 10, 2022
Details
- NPI
- 1154067494
- Entity type
- Individual (NPI-1)
- Name
- Mr. Daniel Blanco III
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 10, 2022
- Certification date
- May 10, 2022
- Last updated
- May 10, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 18KT01338700 | NJ | Yes |
Practice location
48 Elm StWest Orange, NJ 07052-5910
Phone 646-784-1084
Mailing address
48 Elm StWest Orange, NJ 07052-5910
Phone 646-784-1084
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