Individual
ERIC LEWIS KITTLES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MUSTARD ST, ROCHESTER, NY 14609-6980
(585) 336-8100
Mailing address
1 MUSTARD ST, ROCHESTER, NY 14609-6980
(585) 336-8100
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
17500000X
—
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21304
TRAIN
—
Enumeration date
01/23/2019
Last updated
01/23/2019
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