| NPI | 1487198347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY BROOKE FAZZARY President/Owner 607-228-7179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 1931) |
| Enumeration Date | 2016-12-12 |
| Last Update Date | 2016-12-12 |