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1396945374
TARA LOUISE EDMISTON
OLEAN, NY
NPI
1396945374
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NY P58386)
Enumeration Date
2007-07-19
Last Update Date
2007-07-19
Business Address
-- TARA LOUISE EDMISTON PA
515 MAIN ST
OLEAN, NY 14760-1513
Phone number: 716-817-2938
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Mailing Address
-- TARA LOUISE EDMISTON PA
PO BOX 3398
BUFFALO, NY 14240-3398
Phone number: 716-692-3302
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