Individual
HEATHER BRISTOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5949 BROADWAY ST, LANCASTER, NY 14086-9523
(716) 684-1495
Mailing address
5949 BROADWAY ST, LANCASTER, NY 14086-9523
(716) 684-1495
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
015920
NY
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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