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Individual

BRYAN H POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 315-5211
Mailing address
10 GRAHAM RD W, ITHACA, NY 14850-1055
(607) 315-5211

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020051-1
NY

Other

Enumeration date
09/13/2016
Last updated
09/13/2016
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