Individual
MARY LORRAINE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
219 BRYANT ST, BUFFALO, NY 14222-2006
(716) 878-7470
(716) 878-1157
Mailing address
219 BRYANT ST, BUFFALO, NY 14222-2006
(716) 878-7470
(716) 878-1157
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
003877
NY
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Enumeration date
09/12/2008
Last updated
09/12/2008
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