Individual
KELLY KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 LAC DE VILLE BLVD, ROCHESTER, NY 14618-5630
(585) 271-2990
Mailing address
1701 LAC DE VILLE BLVD, ROCHESTER, NY 14618-5630
(585) 271-2990
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008070
NY
Other
Enumeration date
04/19/2018
Last updated
04/19/2018
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