National Provider Identifier
Scott Joesph Ickowski, LMT
Scott Joesph Ickowski, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Kenmore, NY and a listed phone number of (716) 335-9711.
Profile Overview
- NPI
- 1316792765
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- April 19, 2024
- Last Updated
- April 19, 2024
Practice Location
- 989 Kenmore Ave
- Kenmore, NY 14217-2924
Phone: (716) 335-9711
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1316792765
- Entity Type
- Individual
- Last Name
- Ickowski
- First Name
- Scott
- Middle Name
- Joesph
- Credential
- LMT
- Mailing Street Address
- 989 Kenmore Ave
- Mailing City
- Kenmore
- Mailing State
- NY
- Mailing ZIP Code
- 14217-2924
- Mailing Country
- US
- Mailing Phone
- (716) 335-9711
- Practice Street Address
- 989 Kenmore Ave
- Practice City
- Kenmore
- Practice State
- NY
- Practice ZIP Code
- 14217-2924
- Practice Country
- US
- Practice Phone
- (716) 335-9711
- Enumeration Date
- April 19, 2024
- Last Updated
- April 19, 2024
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- April 19, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)