Individual
MRS. SALLY ANN VAN DE MARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
14 HARRIS BUSHVILLE RD, MONTICELLO, NY 12701
(845) 794-0209
(845) 794-0716
Mailing address
PO BOX 426, HARRIS, NY 12742-0426
(845) 794-0209
(845) 794-0716
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005767-1
NY
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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