ALICIA RUSTVOLD

BLUE POINT, NY
NPI1982078036
Former NameALICIA JOHNSON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: NY  260421)
Enumeration Date2015-11-30
Last Update Date2015-11-30
Business Address
-- ALICIA RUSTVOLD LPN
84 EATONDALE AVE
BLUE POINT, NY 11715-1026
Phone number: 631-682-0498
Mailing Address
-- ALICIA RUSTVOLD LPN
84 EATONDALE AVE
BLUE POINT, NY 11715-1026
Phone number: 631-682-0498
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