Individual
MARY E WIXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
223 ONTARIO AVE, SYRACUSE, NY 13209-1134
(315) 447-3373
Mailing address
223 ONTARIO AVE, SYRACUSE, NY 13209-1134
(315) 447-3373
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
639051
NY
Other
Enumeration date
03/26/2018
Last updated
03/26/2018
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