Individual
KARA FASO MIRANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 PORTLAND AVE, ROCHESTER, NY 14621-3065
(585) 697-6000
Mailing address
15 HIGH ST, SODUS, NY 14551-1144
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
001823-1
NY
Other
Enumeration date
04/07/2021
Last updated
04/07/2021
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