Individual
DAWN LOUISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
32 SUMMERVILLE RD, HANNIBAL, NY 13074-2242
(315) 564-8040
Mailing address
32 SUMMERVILLE RD, HANNIBAL, NY 13074-2242
(315) 564-8040
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
239525
NY
Other
Enumeration date
07/23/2008
Last updated
07/23/2008
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