Individual
CCHRISTINE VELIE WILCOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LLPN
Contact information
Practice address
7772 RIDGE RD, GASPORT, NY 14067-9424
(716) 772-7608
Mailing address
7772 RIDGE RD, GASPORT, NY 14067-9424
(716) 772-7608
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
093511-1
NY
Other
Enumeration date
11/29/2010
Last updated
11/29/2010
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