Individual
KATIE MCMILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
495 N MAIN ST, CANANDAIGUA, NY 14424-1283
(585) 393-3515
Mailing address
6470 WATERBURG RD, TRUMANSBURG, NY 14886-9704
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
021158
NY
Other
Enumeration date
08/12/2017
Last updated
08/12/2017
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