National Provider Identifier
Marie Fanham, LMT
Marie Fanham, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Brockport, NY and a listed phone number of (585) 637-3126.
Profile Overview
- NPI
- 1295189017
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- April 18, 2016
- Last Updated
- April 18, 2016
Practice Location
- 29 Clinton St
- Brockport, NY 14420-1803
Phone: (585) 637-3126
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1295189017
- Entity Type
- Individual
- Last Name
- Fanham
- First Name
- Marie
- Credential
- LMT
- Mailing Street Address
- 29 Clinton St
- Mailing City
- Brockport
- Mailing State
- NY
- Mailing ZIP Code
- 14420-1803
- Mailing Country
- US
- Mailing Phone
- (585) 637-3126
- Practice Street Address
- 29 Clinton St
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420-1803
- Practice Country
- US
- Practice Phone
- (585) 637-3126
- Enumeration Date
- April 18, 2016
- Last Updated
- April 18, 2016
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)