Individual
ANNMARIE MUNN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 MOHAWK ST, TUPPER LAKE, NY 12986-1028
(518) 354-2456
Mailing address
12 MOHAWK ST, TUPPER LAKE, NY 12986-1028
(518) 354-2456
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1033054161
NY
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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