Individual provider · NPI-1

Elaine Broiles, LMT

Massage Therapist · Albany, NY

NPI number1396326732
StatusActive
Last updated in NPPESApr 17, 2021

Details

NPI
1396326732
Entity type
Individual (NPI-1)
Name
Elaine Broiles
Credential
LMT
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 17, 2021
Certification date
Apr 17, 2021
Last updated
Apr 17, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225700000X Massage Therapist020874NYYes

Practice location

560 Delaware Ave
Albany, NY 12209-1415

Phone 518-577-5732

Mailing address

5 Chelton Ave
Troy, NY 12180-3106

Phone 518-577-5732

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