| NPI | 1073076725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS PRASHAW O PT Ical Manager 315-393-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332H00000X Eyewear Supplier |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2019-04-10 |
| Last Update Date | 2019-04-10 |