Individual
IVAN DERRICK ATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
50 DODGE ST, ROCHESTER, NY 14606-1523
(585) 576-0068
Mailing address
50 DODGE ST APT B, ROCHESTER, NY 14606-1523
(585) 576-0068
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
NY
Other
Enumeration date
03/18/2022
Last updated
03/18/2022
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