CHRISTOPHER BRADLEY LANGE

ITHACA, NY
NPI1952166118
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: PA  PO000109)
Additional Taxonomies222Z00000X 
(Licence: PA  OH000163)
Enumeration Date2024-02-16
Last Update Date2024-02-16
Business Address
Mr. CHRISTOPHER BRADLEY LANGE CPO
310 TAUGHANNOCK BLVD STE 1A
ITHACA, NY 14850-3251
Phone number: 607-277-6620
Mailing Address
Mr. CHRISTOPHER BRADLEY LANGE CPO
141 CEDAR LN
GROTON, NY 13073-1311
Phone number: 607-330-2106