Organization
TJ FANCY ENTERPRISES LLC
Active
Other names
Sterling Optical 131
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA GREVELDING (OWNER)
(315) 418-2396
Entity
Organization
Contact information
Practice address
104 KASSON RD STE C, CAMILLUS, NY 13031-2248
(315) 487-0327
(315) 487-4425
Mailing address
104 KASSON RD STE C, CAMILLUS, NY 13031-2248
(315) 487-0327
(315) 487-4425
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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