Individual
CRYSTAL GRACE ROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
32 UNDERWOOD AVE, PLATTSBURGH, NY 12901-3626
(518) 335-0045
Mailing address
32 UNDERWOOD AVE, PLATTSBURGH, NY 12901-3626
(518) 335-0045
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
296004-1
NY
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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