Individual
BRANDY CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 MIDDLE ST, GENEVA, NY 14456-1810
(315) 398-9589
Mailing address
14 MIDDLE ST, GENEVA, NY 14456-1810
(315) 398-9589
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
322171
NY
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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