Individual
MICHELLE L DAMICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 WEST AVE, BROCKPORT, NY 14420-1118
(585) 637-3905
Mailing address
8181 SACKETT RD, BERGEN, NY 14416-9350
(585) 301-1746
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006131-01
NY
Other
Enumeration date
05/25/2021
Last updated
05/25/2021
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