Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 099.0083260 | VT |
NPI | 1124393111 |
---|---|
Provider Name | Dr. Klara Lee Carson |
First Address | Henrietta, NY 14467-8945 |
Second Address | Rochester, NY 14623-2805 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2012 |
Last Update Date | 09/03/2012 |