National Provider Identifier
Susan Dorinda Hetrick, LMT, MLD
Susan Dorinda Hetrick, LMT, MLD is listed in the NPPES registry with a primary specialty of Massage Therapist in Lockport, NY and a listed phone number of (716) 622-6111.
Profile Overview
- NPI
- 1730607052
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- September 07, 2017
- Last Updated
- June 09, 2021
Practice Location
- 7397 Ridge RD
- Lockport, NY 14094-9458
Phone: (716) 622-6111
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1730607052
- Entity Type
- Individual
- Last Name
- Hetrick
- First Name
- Susan
- Middle Name
- Dorinda
- Credential
- LMT, MLD
- Mailing Street Address
- 7397 Ridge RD
- Mailing City
- Lockport
- Mailing State
- NY
- Mailing ZIP Code
- 14094-9458
- Mailing Country
- US
- Mailing Phone
- (716) 622-6111
- Mailing Fax
- (716) 772-5322
- Practice Street Address
- 7397 Ridge RD
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-9458
- Practice Country
- US
- Practice Phone
- (716) 622-6111
- Practice Fax
- (716) 772-5322
- Enumeration Date
- September 07, 2017
- Last Updated
- June 09, 2021
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- June 09, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)