Individual
KIMBERLY JO TUTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
495 N MAIN ST, CANANDAIGUA, NY 14424-1283
(585) 393-3515
(585) 393-3515
Mailing address
495 N MAIN ST, CANANDAIGUA, NY 14424-1283
(585) 393-3515
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03385908
—
NY
Enumeration date
07/16/2007
Last updated
07/28/2016
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