Individual
JAC SAMUEL DORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5828 LEWISTON ROAD, LEWISTON, NY 14092
(716) 298-2900
Mailing address
262 ERIN ROAD, MEDINA, NY 14103
(716) 940-3946
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0
NY
Other
Enumeration date
07/14/2023
Last updated
07/14/2023
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