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1821305194
KIMBERLY T BASCOM
QUEENSBURY, NY
NPI
1821305194
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: NY 005165)
Enumeration Date
2010-09-08
Last Update Date
2010-09-08
Business Address
-- KIMBERLY T BASCOM PTA
429 AVIATION RD
QUEENSBURY, NY 12804-2914
Phone number: 518-824-1600
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Mailing Address
-- KIMBERLY T BASCOM PTA
14 FACTORY ST
GRANVILLE, NY 12832-1312
Phone number: 518-361-9753
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