Individual
MAXWELL C GILMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 IVY ST, ELMIRA, NY 14905-1646
(607) 737-7804
(607) 735-7510
Mailing address
101 RACHEL CARSON WAY, ITHACA, NY 14850-9395
(607) 229-6369
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012749-01
NY
Other
Enumeration date
03/30/2022
Last updated
03/30/2022
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