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Individual

MRS. LAURA MARIE FAVARO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT, MS

Contact information

Practice address
4498 MAIN ST, SUITE 24, AMHERST, NY 14226-3826
(716) 839-1550
(716) 839-1696
Mailing address
4498 MAIN ST, SUITE #24, AMHERST, NY 14226-3826
(716) 839-1550
(716) 839-1696

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
28030
NY
2251X0800X
Orthopedic Physical Therapist
Primary
028030
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02792478
NY
Enumeration date
01/24/2007
Last updated
04/30/2009
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