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1154773893
LARISSA FONVILLE
WILLIAMSVILLE, NY
NPI
1154773893
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 325606)
Enumeration Date
2016-07-06
Last Update Date
2016-07-06
Business Address
-- LARISSA FONVILLE LPN
2250 WEHRLE DR SUITE 1
WILLIAMSVILLE, NY 14221-7034
Phone number: 716-276-2123
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Mailing Address
-- LARISSA FONVILLE LPN
2250 WEHRLE DR SUITE 1
WILLIAMSVILLE, NY 14221-7034
Phone number: 716-276-2123
Copy
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