Individual
DR. LESLEY WILLIS VANDERMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, ATC
Contact information
Practice address
29 CARRIAGE HL W, BUFFALO, NY 14221-2103
(814) 558-1788
Mailing address
29 CARRIAGE HL W, BUFFALO, NY 14221-2103
(814) 558-1788
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004262-01
NY
Other
Enumeration date
10/26/2015
Last updated
10/09/2024
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