Individual
ROSETTE MUTAS AVILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2850 GRAND ISLAND BLVD, GRAND ISLAND, NY 14072-1251
(716) 773-5900
Mailing address
1305 KENWOOD DR, NORTH WALES, PA 19454-3707
(215) 650-1654
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011726
NY
Other
Enumeration date
05/12/2022
Last updated
05/12/2022
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