Individual
MARY CASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
256 SUNSET LAKE RD, LIBERTY, NY 12754-2847
(845) 292-8640
Mailing address
256 SUNSET LAKE RD, LIBERTY, NY 12754-2847
(845) 292-8640
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
000390-1
NY
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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