Individual
MATTHEW GLADLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
805 CAROLINE ST, OGDENSBURG, NY 13669-3303
(315) 393-3999
Mailing address
805 CAROLINE ST, OGDENSBURG, NY 13669-3303
(315) 393-3999
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
445524456
NY
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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