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Individual

ANDREA LEE HEROLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DC

Contact information

Practice address
905 LAKE ST, ANGOLA, NY 14006
(716) 998-6980
Mailing address
905 LAKE ST, ANGOLA, NY 14006-9281
(716) 549-1999
(716) 549-1990

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X012238-1
NY

Other

Enumeration date
09/18/2012
Last updated
05/11/2020
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