Individual
DR. THOMAS RICHARD NYSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
80 EAST MAIN ST, CANTON, NY 13617
(315) 386-8121
(315) 386-8121
Mailing address
80 EAST MAIN ST, CANTON, NY 13617
(315) 386-8121
(315) 386-8121
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N2966
NY
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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