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Individual

PAIGE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
4455 PORTER RD, NIAGARA FALLS, NY 14305-3309
(716) 725-3549
Mailing address
4455 PORTER RD, NIAGARA FALLS, NY 14305-3309

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
79004
NATA
NY
01
BOC250602
BOC
NY
Enumeration date
05/16/2016
Last updated
05/16/2016
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