Individual
MRS. AMANDA CORNWALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6 MCMASTER ST, BATH, NY 14810-1615
(607) 794-8386
Mailing address
6 MCMASTER ST, BATH, NY 14810-1615
(607) 794-8386
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
310612-1
NY
Other
Enumeration date
12/03/2014
Last updated
12/03/2014
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