Individual
MARY J. IRVING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
107 SCHENECTADY AVE, COBLESKILL, NY 12043-1704
(518) 255-5126
Mailing address
984 TITUS LAKE RD, JEFFERSON, NY 12093-2714
(607) 643-5483
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000054-01
—
Other
Enumeration date
10/21/2022
Last updated
10/21/2022
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