Individual
CONNIE MARIE ZACHOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
21 BENNETT HOLLOW RD, WALTON, NY 13856-3210
(607) 434-3221
Mailing address
21 BENNETT HOLLOW RD, WALTON, NY 13856-3210
(607) 434-3221
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
305578
NY
Other
Enumeration date
09/17/2013
Last updated
09/19/2013
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