| NPI | 1982755948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW C. ALLEN Owner 315-363-4942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NY TUV002717) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV006206) |
| 152W00000X Optometrist (Licence: NY TUV007184) | |
| 152W00000X Optometrist (Licence: NY TUV006131) | |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2013-09-17 |