Individual
MRS. DAWN M BAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS,OTR/L
Contact information
Practice address
106 MONTCALM ST, NORTHWOODS WELLNESS PHYSICAL & OCCUPATIONAL THERAPY, TICONDEROGA, NY 12883-1353
(518) 585-9285
(518) 585-9286
Mailing address
106 MONTCALM ST, NORTHWOODS WELLNESS PHYSICAL & OCCUPATIONAL THERAPY, TICONDEROGA, NY 12883-4101
(518) 585-9285
(518) 585-9286
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1598948259
NY
225100000X
Physical Therapist
1679756332
NY
225X00000X
Occupational Therapist
Primary
007563-1
NY
Other
Enumeration date
07/20/2007
Last updated
06/12/2008
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