Individual
CAROL COLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 BULL RUN RD, MALONE, NY 12953-2622
(518) 483-8548
Mailing address
113 BULL RUN RD, MALONE, NY 12953-2622
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
280582-1
NY
Other
Enumeration date
10/09/2007
Last updated
10/09/2007
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