Individual
DAWN MARIE DEGROAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
42298 MEW CONNECTICUT RD, THERESA, NY 13691
(315) 755-8353
Mailing address
42298 MEW CONNECTICUT RD, THERESA, NY 13691
(315) 755-8353
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
10309686
NY
Other
Enumeration date
06/17/2015
Last updated
06/17/2015
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