Individual
MISS MICHELLE MARIE PEARSALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
183 WEBSTER ST, MALONE, NY 12953-2226
(518) 483-7802
Mailing address
284 PORTER RD, MALONE, NY 12953-3903
(518) 483-6691
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005498
NY
Other
Enumeration date
09/17/2010
Last updated
09/17/2010
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