Individual
MRS. CODY CALHOUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 W 1ST ST, OSWEGO, NY 13126-2045
(315) 342-9575
Mailing address
211 COLORADO AVE, WATERTOWN, NY 13601-3005
(570) 228-1350
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1002913151
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002913151
NYSDE
NY
Enumeration date
12/31/2015
Last updated
12/31/2015
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