Individual
AUTUMN TIMOTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5871 GROVELAND STATION RD, MOUNT MORRIS, NY 14510-9767
(585) 658-4023
Mailing address
2802 RETSOF AVENUE, RETSOF, NY 14539
(585) 322-3864
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NY
Other
Enumeration date
09/24/2013
Last updated
09/24/2013
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