National Provider Identifier
Tracy Sullivan Pelletier, LMT
Tracy Sullivan Pelletier, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Ithaca, NY and a listed phone number of (607) 379-0547.
Profile Overview
- NPI
- 1861119000
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- October 27, 2022
- Last Updated
- October 27, 2022
Practice Location
- 301 S Geneva St
- Ithaca, NY 14850-5445
Phone: (607) 379-0547
Mailing Address
- 100 Norris Ave
- Auburn, NY 13021-1315
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1861119000
- Entity Type
- Individual
- Last Name
- Pelletier
- First Name
- Tracy
- Middle Name
- Sullivan
- Credential
- LMT
- Mailing Street Address
- 100 Norris Ave
- Mailing City
- Auburn
- Mailing State
- NY
- Mailing ZIP Code
- 13021-1315
- Mailing Country
- US
- Mailing Phone
- (607) 379-0547
- Practice Street Address
- 301 S Geneva St
- Practice City
- Ithaca
- Practice State
- NY
- Practice ZIP Code
- 14850-5445
- Practice Country
- US
- Practice Phone
- (607) 379-0547
- Enumeration Date
- October 27, 2022
- Last Updated
- October 27, 2022
- Sex
- Female
- Sole Proprietor
- Yes
- Certification Date
- October 27, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)