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Individual

MICHELLE B FAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
192 PARK CLUB LN, WILLIAMSVILLE, NY 14221-5270
(716) 632-9200
Mailing address
8929 GASKIN RD, CLARENCE, NY 14031-1412
(716) 632-9200

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2770586
NY

Other

Enumeration date
12/09/2025
Last updated
12/09/2025
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