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Individual

MR. BRIAN K BOISVERT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5106 RIDGE ROAD, WILLIAMSON, NY 14589
(315) 589-9391
(315) 589-7418
Mailing address
5106 RIDGE ROAD, WILLIAMSON, NY 14589
(315) 589-9391
(315) 589-7418

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02556018
NY
Enumeration date
11/20/2006
Last updated
07/09/2007
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