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1306488259
JOHANNA ELAINE EVANS
OSWEGO, NY
NPI
1306488259
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: NY 010218)
Enumeration Date
2019-10-11
Last Update Date
2019-10-11
Business Address
JOHANNA ELAINE EVANS
159 W 1ST ST
OSWEGO, NY 13126-2045
Phone number: 315-342-9575
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Mailing Address
JOHANNA ELAINE EVANS
PO BOX 45
CENTRAL SQUARE, NY 13036-0045
Phone number: 315-440-7883
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