| NPI | 1528114311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON EDGAR WUEBBOLT President/Owner 716-484-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| 156FX1100X Technician/Technologist, Ophthalmic (Licence: PA MD052930L) | |
| 156FX1100X Technician/Technologist, Ophthalmic (Licence: PA MD065707L) | |
| 163WA2000X Registered Nurse, Administrator | |
| 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery | |
| 163WG0000X Registered Nurse, General Practice | |
| 163WX1100X Registered Nurse, Ophthalmic | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2021-10-13 |