Individual
JUSTICE MYKEL RAYBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1661 VALLEY DR, SYRACUSE, NY 13207-2853
(315) 246-3989
Mailing address
102 STINARD AVE, SYRACUSE, NY 13207-1242
(315) 246-3989
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
579482489
NY
172A00000X
Driver
579482489
—
Other
Enumeration date
02/08/2022
Last updated
02/08/2022
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