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Individual

CHERYL DEAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
20773 REASONER RD, WATERTOWN, NY 13601-5270
(315) 408-4917
Mailing address
20773 REASONER RD, WATERTOWN, NY 13601-5270
(315) 408-4917

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
294743
NY

Other

Enumeration date
07/19/2010
Last updated
07/19/2010
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