Individual
COLLEEN KLOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 MAPLE RD, WILLIAMSVILLE, NY 14221-3647
(716) 568-3514
Mailing address
1540 MAPLE RD, WILLIAMSVILLE, NY 14221-3647
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
027835-01
NY
Other
Enumeration date
01/14/2022
Last updated
01/14/2022
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