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1811355845
TEQUILA IVEY
ROCHESTER, NY
NPI
1811355845
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 316825)
Enumeration Date
2016-02-04
Last Update Date
2016-02-04
Business Address
TEQUILA IVEY LPN
1038 PLYMOUTH AVE S
ROCHESTER, NY 14608-2941
Phone number: 585-503-6255
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Mailing Address
TEQUILA IVEY LPN
1038 PLYMOUTH AVE S
ROCHESTER, NY 14608-2941
Phone number: 585-503-6255
Copy
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