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Individual

MRS. LYNN MARIE WHITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L PTA

Contact information

Practice address
255 GROS BLVD, HERKIMER, NY 13350-1455
(315) 866-8562
Mailing address
55 W CLARK ST, ILION, NY 13357-1101
(315) 360-6241

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
007498-1
NY
225XP0200X
Pediatric Occupational Therapist
Primary
011270-1
NY

Other

Enumeration date
12/20/2011
Last updated
12/20/2011
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