Individual
BEVERLY VANTREESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3 SPRUCE ST, CANISTEO, NY 14823-1058
(607) 382-8085
Mailing address
3 SPRUCE ST, CANISTEO, NY 14823-1058
(607) 698-4003
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
306325
NY
Other
Enumeration date
10/31/2013
Last updated
10/31/2013
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