National Provider Identifier

Kristy Genung Dibelka, LMT

Kristy Genung Dibelka, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Brockport, NY and a listed phone number of (585) 697-4489.

NPI 1770755274Brockport, NYMassage Therapist

Profile Overview

NPI
1770755274
Provider Type
Individual
Primary Specialty
Massage Therapist
Enumeration Date
March 25, 2008
Last Updated
March 25, 2008

Practice Location

  • 4079 Lake RD N
  • Brockport, NY 14420-1517

Phone: (585) 697-4489

Specialties

  • Massage Therapist (225700000X)
Full Record
NPI
1770755274
Entity Type
Individual
Last Name
Dibelka
First Name
Kristy
Middle Name
Genung
Name Prefix
MS.
Credential
LMT
Mailing Street Address
4079 Lake RD N
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-1517
Mailing Country
US
Mailing Phone
(585) 697-4489
Practice Street Address
4079 Lake RD N
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1517
Practice Country
US
Practice Phone
(585) 697-4489
Enumeration Date
March 25, 2008
Last Updated
March 25, 2008
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Massage Therapist (225700000X)