Individual
CHANTALLE HURTGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2250 WEHRLE DR, SUITE 1, WILLIAMSVILLE, NY 14221-7034
(716) 276-2123
(716) 276-2129
Mailing address
2753 ANGLING RD, MEDINA, NY 14103-9651
(585) 615-1957
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
297340
NY
Other
Enumeration date
06/25/2009
Last updated
06/25/2009
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