John Schuyler Gammon II, LMT
Massage Therapist in Lisbon, NY. Individual provider (NPI-1).
NPI number1235304577
StatusActive
Last updated in NPPESApr 28, 2008
Details
- NPI
- 1235304577
- Entity type
- Individual (NPI-1)
- Name
- Mr. John Schuyler Gammon II
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 28, 2008
- Last updated
- Apr 28, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 0176961 | NY | Yes |
Practice location
488 Bull Run RdLisbon, NY 13658-3257
Phone 315-393-4204
Mailing address
488 Bull Run RdLisbon, NY 13658-3257
Phone 315-393-4204
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