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Individual

LISA ANGLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8194 BIELBY RD, ROME, NY 13440-1915
(315) 334-1260
Mailing address
123 COOPER STREET, ORISKANY FALLS, NY 13425

Taxonomy

Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
691465
NY

Other

Enumeration date
09/25/2014
Last updated
09/25/2014
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