Individual
CASEY COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
531 EISENHOWER AVE, ANGOLA, NY 14006-9155
(716) 512-0515
Mailing address
531 EISEHOWER AVE, ANGOLA, NY 14006
(716) 512-0515
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306889-1
NY
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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