Individual
COURTNEY KINGSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14 KENNEDY PKWY, CORTLAND, NY 13045-1435
(607) 756-9941
Mailing address
13334 W SHERBERN DR, CARMEL, IN 46032-1309
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
025746
NY
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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