Individual
MR. KYLE W MULVANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
45 RIVER ST, CHATEAUGAY, NY 12920-2003
(518) 497-8007
(518) 497-7009
Mailing address
PO BOX 236, CHATEAUGAY, NY 12920-0236
(518) 497-8007
(518) 497-7009
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
CPO02555
NY
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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