| NPI | 1568657443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MICHAEL ROTH Manager/Optometrist 315-475-2778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV006532) |
| Enumeration Date | 2007-09-13 |
| Last Update Date | 2007-12-26 |