Individual ProviderLaura WallerMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address7293 Buckley Rd Ste 102, Syracuse, NY 13212-2648(315) 937-5954PECOS EnrollmentBased on the most recent information from CMS, provider Laura Waller does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1144612201Provider TypeIndividualFull NameWaller, LauraCredentialLMTGenderFemaleSole ProprietorNoEnumeration Date2/26/2015Last Updated10/5/2023Contact InformationPractice LocationPractice Address7293 Buckley Rd Ste 102, Syracuse, NY 13212-2648Phone(315) 937-5954FaxUnlisted FaxMailing LocationMailing Address7293 Buckley Rd Ste 102, Syracuse, NY 13212-2648Phone(315) 937-5954FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense023440New YorkCode225700000XDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense7501006233Michigan