National Provider Identifier
Theresa M Derose, LMT
Theresa M Derose, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Cheektowaga, NY and a listed phone number of (716) 866-4452.
Profile Overview
- NPI
- 1982997888
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- May 25, 2011
- Last Updated
- May 25, 2011
Practice Location
- 704 Beach RD
- Cheektowaga, NY 14225-1756
Phone: (716) 866-4452
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1982997888
- Entity Type
- Individual
- Last Name
- Derose
- First Name
- Theresa
- Middle Name
- M
- Credential
- LMT
- Mailing Street Address
- 704 Beach RD
- Mailing City
- Cheektowaga
- Mailing State
- NY
- Mailing ZIP Code
- 14225-1756
- Mailing Country
- US
- Mailing Phone
- (716) 866-4452
- Mailing Fax
- (716) 632-2492
- Practice Street Address
- 704 Beach RD
- Practice City
- Cheektowaga
- Practice State
- NY
- Practice ZIP Code
- 14225-1756
- Practice Country
- US
- Practice Phone
- (716) 866-4452
- Practice Fax
- (716) 632-2492
- Enumeration Date
- May 25, 2011
- Last Updated
- May 25, 2011
- Sex
- Female
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)