Individual
RENEE WEDDERBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7 DANIELLE CT, MONTGOMERY, NY 12549-2506
(862) 397-9061
Mailing address
7 DANIELLE CT, MONTGOMERY, NY 12549-2506
(862) 397-9061
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
JRM6786
NY
Other
Enumeration date
06/09/2022
Last updated
06/09/2022
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