| NPI | 1124462452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SHABA YALLDO O PT Ometrist 585-994-4499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MI 4901004524) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2021-10-18 |