National Provider Identifier

Kelly R Maracle, LMT

Kelly R Maracle, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Buffalo, NY and a listed phone number of (716) 884-2826.

NPI 1699192898Buffalo, NYMassage Therapist

Profile Overview

NPI
1699192898
Provider Type
Individual
Primary Specialty
Massage Therapist
Enumeration Date
March 25, 2014
Last Updated
April 07, 2014

Practice Location

  • 890 Elmwood Ave
  • Buffalo, NY 14222-1434

Phone: (716) 884-2826

Mailing Address

  • 13967 Route 438
  • Gowanda, NY 14070-9709

Specialties

  • Massage Therapist (225700000X)
Full Record
NPI
1699192898
Entity Type
Individual
Last Name
Maracle
First Name
Kelly
Middle Name
R
Name Prefix
MS.
Credential
LMT
Mailing Street Address
13967 Route 438
Mailing City
Gowanda
Mailing State
NY
Mailing ZIP Code
14070-9709
Mailing Country
US
Mailing Phone
(716) 982-3967
Practice Street Address
890 Elmwood Ave
Practice City
Buffalo
Practice State
NY
Practice ZIP Code
14222-1434
Practice Country
US
Practice Phone
(716) 884-2826
Enumeration Date
March 25, 2014
Last Updated
April 07, 2014
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Massage Therapist (225700000X)
Other Identifiers
023019-1 (NY, Ny State License Number)