Individual
MRS. WENDY SUE MICCA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
422 CLINTON AVE S, ROCHESTER, NY 14620-1103
(585) 697-5723
(585) 232-2972
Mailing address
19 PEWTER ROCK, WEBSTER, NY 14580
(585) 697-5723
(595) 232-2972
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006398
NY
Other
Enumeration date
11/01/2013
Last updated
11/01/2013
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