Individual
MR. MYLES ALEXANDER NICHOLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
620 WESTFALL RD, ROCHESTER, NY 14620-4610
(585) 461-8842
Mailing address
649 MAGEE AVE, ROCHESTER, NY 14613-1015
(585) 647-6058
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006515-1
NY
Other
Enumeration date
07/23/2008
Last updated
07/23/2008
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