Individual
ELIZABETH JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
355 FAYETTE AVE, BUFFALO, NY 14223-2409
(716) 341-5519
Mailing address
355 FAYETTE AVE, BUFFALO, NY 14223-2409
(716) 341-5519
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
010726-1
NY
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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