Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1063983864 |
---|---|
Provider Name | Allensia Annette Brown |
First Address | Buffalo, NY 14215-3459 |
Second Address | Buffalo, NY 14215-3459 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2018 |
Last Update Date | 06/12/2018 |