Individual
MRS. CRYSTAL LYNN MILLERD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 VIENNA ST, PALMYRA, NY 14522-1516
(315) 576-4484
Mailing address
320 VIENNA ST, PALMYRA, NY 14522-1516
(315) 576-4484
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
275215-1
NY
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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