Organization
NORTH COUNTRY SPORTS MEDICINE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LORI M BALDWIN (PRACTICE ADMINISTRATOR)
(518) 793-9156
Entity
Organization
Contact information
Practice address
25 WILLOWBROOK ROAD, SUITE 2, QUEENSBURY, NY 12804
(518) 793-9156
(518) 793-6591
Mailing address
25 WILLOWBROOK ROAD, SUITE 2, QUEENSBURY, NY 12804
(518) 793-9156
(518) 793-6591
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02194627
—
NY
Enumeration date
10/19/2006
Last updated
09/02/2011
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