Individual
TODD T RODABAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
126 S MAIN ST, HORSEHEADS, NY 14845-2443
(607) 739-9121
Mailing address
126 S MAIN ST, HORSEHEADS, NY 14845-2443
(607) 739-9121
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
005967
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02064217
—
NY
Enumeration date
06/04/2007
Last updated
07/08/2007
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