Individual
TERA PATENAUDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., ATC
Contact information
Practice address
110 8TH ST, ECAV, TROY, NY 12180-3522
(518) 276-2884
Mailing address
5 TATHUM TRCE, GANSEVOORT, NY 12831-2448
(518) 859-3083
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001748
NY
Other
Enumeration date
11/07/2011
Last updated
11/07/2011
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