Individual
DR. MICHAEL ANTHONY PERSOLEO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
208 N MEADOW ST, ITHACA, NY 14850-4027
(607) 272-0006
Mailing address
3A2 CANDLEWYCK PARK, ITHACA, NY 14850-1320
(607) 272-0006
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
X012117-1
NY
Other
Enumeration date
01/03/2012
Last updated
01/03/2012
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