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Individual

MR. ZACHARY JOHN HOLLEY IVES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NYS PEER SPECIALIST

Contact information

Practice address
1003 PARK ST, OGDENSBURG, NY 13669-3911
(315) 713-9090
Mailing address
729 PICKERING ST APT 1, OGDENSBURG, NY 13669-3387
(315) 713-9090

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
12/05/2023
Last updated
12/05/2023
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