Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gavin Lance Powell, MASSAGETHERAPIST

Individual provider Massage Therapist · NPI 1417659509

Gavin Lance Powell, MASSAGETHERAPIST is a Massage Therapist in New York, New York. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2023

Practice location Address checks out

630 W 173rd St
New York, NY 10032-1413
Phone: (810) 835-9314
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence MT014426 (GA)

Record details

NPI number1417659509
Entity typeIndividual (Type 1)
GenderMale
Credentials MASSAGETHERAPIST
Sole proprietorYes
NPI enumeratedMarch 21, 2023
Last updated in NPPESMarch 21, 2023
Certification dateMarch 21, 2023

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