Individual
TIFFANY M WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 HUDSON AVE, ROCHESTER, NY 14621-1701
(585) 266-1830
Mailing address
1490 HUDSON AVE, ROCHESTER, NY 14621
(585) 266-1830
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
008828
NY
Other
Enumeration date
01/04/2018
Last updated
01/04/2018
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