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Organization

TOWN OF PROVIDENCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN COLLYER (TOWN SUPERVISOR)
(518) 882-6541
Entity
Organization

Contact information

Practice address
2175 BALLSTON-GALWAY RD., GALWAY, NY 12074-1111
(585) 882-6541
Mailing address
8020 E MAIN RD, LE ROY, NY 14482-9704

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6246
NY

Other

Enumeration date
11/18/2013
Last updated
09/04/2014
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