Individual
MS. AMY-JO LAVAY BURROUGHS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1 SCHOOL ST, SUITE 107, GOWANDA, NY 14070-1133
(716) 241-7067
(716) 241-7197
Mailing address
1 SCHOOL STREET, SUITE 107, GOWANDA, NY 14070-1133
(716) 241-7067
(716) 241-7197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010035
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02626126
—
NY
01
—
6209596955
DEPARTMENT OF TRANSPORTATION
NY
Enumeration date
04/17/2006
Last updated
06/23/2014
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