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Individual

MS. ANDREA MICHELLE LEGG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, DPT, M.ED., ATC

Contact information

Practice address
4107 W GENESEE ST STE 300, SYRACUSE, NY 13219-1952
(315) 635-5000
(315) 492-1203
Mailing address
606 ELLINGTON CT, CAMILLUS, NY 13031-2058
(315) 787-4570

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
035863
NY
2255A2300X
Athletic Trainer
020102321
NY

Other

Enumeration date
02/19/2007
Last updated
05/14/2021
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