Individual
CASEY WILLIAMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
521 N CAMPUS, ITHACA, NY 14853-6007
(607) 351-7464
Mailing address
521 N CAMPUS, ITHACA, NY 14853-6007
(607) 351-7464
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
003291
NY
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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