Most Relevant Information
Provider Data
| NPI Number: | 1003559592 |
| Provider Name: | MINNICK HALL |
| Entity Type: | Individual |
| Taxonomy Code: | 174400000X |
| Specialty: | Specialist |
| License Number: | 1816198 |
Most Important Dates
| Enumeration Date: | 04/14/2022 |
| Last Updated: | 04/14/2022 |
Provider Practice Location
36 BELL RD
CHAZY
NY
129212261
Practice Location Phone/Fax
| Phone: | 5184202603 |
| Fax: |
Provider Mailing Location
36 BELL RD
CHAZY
NY
129212261
Provider Mailing Phone/Fax
| Phone: | 5184202603 |
| Fax: |