Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 047517 | NY |
NPI | 1073281382 |
---|---|
Provider Name | Allyson Hildreth |
First Address | Watertown, NY 13601-0519 |
Second Address | Mexico, NY 13114-3229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2021 |
Last Update Date | 01/09/2021 |