Individual
ANTHONY COLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1704 STATE ST, WATERTOWN, NY 13601-3102
(315) 788-7430
Mailing address
PO BOX 6550, WATERTOWN, NY 13601-6550
(315) 788-7430
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
P113245
NY
Other
Enumeration date
12/20/2021
Last updated
12/20/2021
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