Stull, Clark Edmon

Stull, Clark Edmon is an individual health care provider with primary practice located at 2605 Brewerton Rd , Syracuse NY 13211-1147. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Stull, Clark Edmon can be contacted via phone (315) 455-9355.

Contact Information

Primary practice address
2605 Brewerton Rd Syracuse NY 13211-1147
Phone: (315) 455-9355
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 024325 New York

Profile Details

NPI number 1558671941
LBN Legal business name Stull, Clark Edmon
Credentials LMT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2010
Last updated Oct 19th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558671941 NPPES
New York Other 024325 NY STATE EDUCATION DEPARTMENT

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