Individual
MRS. CRISTIN ETHERINGTON ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
68 RAILROAD ST, BERNHARDS BAY, NY 13028-3174
(315) 450-4099
Mailing address
68 RAILROAD ST, BERNHARDS BAY, NY 13028-3174
(315) 450-4099
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/25/2012
Last updated
05/25/2012
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