Individual
MR. EDWARD KEVIN MOCK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.M.A.
Contact information
Practice address
98 N 2ND ST, SUITE 100, FULTON, NY 13069-1254
(315) 326-3555
Mailing address
6207 DIFFIN RD, CICERO, NY 13039-9399
(315) 420-7272
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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