Individual
MR. BRENT PAUL AST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AEMT-CC
Contact information
Practice address
6763 MINNICK RD LOT 19, LOCKPORT, NY 14094-9105
(716) 352-0504
(716) 352-0504
Mailing address
7195 PLANK RD, LOCKPORT, NY 14094-9352
(716) 352-0504
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
374087
NY
Other
Enumeration date
07/26/2017
Last updated
06/16/2018
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