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Individual

CASSANDRA MARIE LADD-BASHFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
19472 US RT 11, WATERTOWN, NY 13601
(315) 782-6126
(315) 782-3816
Mailing address
19472 US RT 11, WATERTOWN, NY 13601
(315) 782-6126
(315) 782-3816

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
031876
NY

Other

Enumeration date
09/23/2009
Last updated
09/23/2009
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