Provider Demographics
NPI:1346693587
Name:FOX TONER, NICOLE MARIE (LMT)
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:MARIE
Last Name:FOX TONER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MAIN ST
Mailing Address - Street 2:SUITE 218
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-6606
Mailing Address - Country:US
Mailing Address - Phone:607-592-9600
Mailing Address - Fax:
Practice Address - Street 1:17 MAIN ST
Practice Address - Street 2:STE 218
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-6606
Practice Address - Country:US
Practice Address - Phone:607-592-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-22
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018003225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist