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1487869087
GLENN CHAMPAGNE
MALONE, NY
NPI
1487869087
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
208D00000X General Practice
(Licence: NY 127279-1)
Enumeration Date
2007-05-14
Last Update Date
2007-07-08
Business Address
-- GLENN CHAMPAGNE M.D.
BARE HILL ROAD FRANKLIN CORRECTIONAL FACILITY
MALONE, NY 12953
Phone number: 518-483-6040
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Mailing Address
-- GLENN CHAMPAGNE M.D.
130 MOODY RD
MALONE, NY 12953-3819
Phone number: 518-483-1120
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