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1649536103
CRYSTAL CHANEL DILLARD
CORAM, NY
NPI
1649536103
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 308880-1)
Enumeration Date
2012-04-09
Last Update Date
2012-04-09
Business Address
Ms. CRYSTAL CHANEL DILLARD lpn
13 POLK CT
CORAM, NY 11727-3915
Phone number: 631-732-0787
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Mailing Address
Ms. CRYSTAL CHANEL DILLARD lpn
13 POLK CT
CORAM, NY 11727-3915
Phone number: 631-732-0787
Copy
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