Provider Demographics
NPI:1790854396
Name:DACHTLER, BIRGITH (LMT)
Entity Type:Individual
Prefix:
First Name:BIRGITH
Middle Name:
Last Name:DACHTLER
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 1:693 EAST AVE
Mailing Address - Street 2:RETREAT HOUSE MASSAGE & WELLNESS CTR
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14607-2152
Mailing Address - Country:US
Mailing Address - Phone:585-738-8899
Mailing Address - Fax:585-271-7429
Practice Address - Street 1:693 EAST AVE
Practice Address - Street 2:RETREAT HOUSE MASSAGE & WELLNESS CTR
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14607-2152
Practice Address - Country:US
Practice Address - Phone:585-738-8899
Practice Address - Fax:585-271-7429
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016260225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY137069GGOtherMASSAGE THERAPY