Individual
CHARISSA L. DUPONT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5570 MAIN ST, WILLIAMSVILLE, NY 14221-5477
(716) 250-4137
Mailing address
5657 E MAIN STREET RD, BATAVIA, NY 14020-9609
(585) 746-3284
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
008644-1
NY
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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