| NPI | 1134697089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH JAMES CAMPESE Owner 716-462-8519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2018-11-08 |
| Last Update Date | 2018-12-14 |