Individual
IRIS LOUISE MAXWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5 MAXWELL CT, SYRACUSE, NY 13207-2533
(315) 491-6730
Mailing address
5 MAXWELL CT, SYRACUSE, NY 13207-2533
(315) 491-6730
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
299093-1
NY
Other
Enumeration date
12/05/2010
Last updated
10/22/2012
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