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General NPI Number Information
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NPI Number | 1255811253
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Entity Type | Individual
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Provider Name | LINDSEY WRATTEN
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Gender | Female
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Dates
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Enumeration Date | 08/19/2018
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Last Update Date | 08/19/2018
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Provider Practice Location Address
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Address Line | 506 S FRANKLIN ST
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City | WATKINS GLEN
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State | NY
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Zip | 14891-1524
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Country | US
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Telephone | 607-535-7350
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Fax |
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Provider Business Mailing Address
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Address Line | 1108 MASON RD
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City | WATERVILLE
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State | NY
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Zip | 13480-2102
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 064448
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License Number State | NY
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