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Individual

ALLISON LEIGH KOLKHORST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1 RAPP RD, ALBANY, NY 12203-4491
(518) 867-3061
Mailing address
1 SKYLINE DR, LATHAM, NY 12110-5221

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
17400000X
NY
Enumeration date
09/07/2017
Last updated
09/07/2017
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Product
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